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KRYSTAL CAMPBELL LCSW
NPI 1417520156
Social Worker - Clinical in Fontana, CA

Active since July 21, 2021PECOS Enrolled
15111 HOLIDAY DR, FONTANA, CA 92336(909) 827-4488 Get Directions Write a Review

NPPES record last updated: October 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 27, 2023, Jul 21, 2021 (2 updates tracked since 2021).

About Krystal Campbell Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KRYSTAL CAMPBELL LCSW (NPI 1417520156) is an individual clinical provider in Fontana, California, licensed in California (94980) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417520156
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKRYSTAL CAMPBELLCredential: LCSW
Location Address15111 HOLIDAY DRFontana, CA 92336-4461
Mailing Address15111 Holiday DrFontana, CA 92336-4461 · (909) 827-4488
Phone(909) 827-4488
Sole ProprietorYes
Enumeration DateJuly 21, 2021
Last NPPES UpdateOctober 27, 20232 updates tracked since enumeration
NPPES CertifiedJuly 21, 2021
✔ NPI 1417520156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 94980
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
15111 HOLIDAY DR, Fontana, CA 92336
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Krystal Campbell Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Krystal Campbell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group
27 mi
Health Maintenance Organization
441 N LAKEVIEW AVE
Anaheim, CA 92807
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1952333460 (714) 279-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92336 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Krystal Campbell's NPI number?

The NPI number for Krystal Campbell is 1417520156. It was assigned to this individual provider in the NPPES registry on July 21, 2021.

Where is Krystal Campbell located?

Krystal Campbell practices at 15111 Holiday Dr, Fontana, CA 92336. The listed phone number is (909) 827-4488.

What is Krystal Campbell's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Krystal Campbell enrolled in Medicare?

Yes. Krystal Campbell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Krystal Campbell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Krystal Campbell reassigns Medicare benefits to Southern California Permanente Medical Group (Anaheim, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Krystal Campbell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Krystal Campbell was last updated on October 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.