CRYSTAL MARIE DICKERSON
NPI 1871917468
Marriage & Family Therapist in Santa Clara, CA

Q: What is Crystal Dickerson's NPI number?

The NPI number for Crystal Dickerson is 1871917468. It was assigned to this individual provider in the NPPES registry on February 18, 2014.

Q: What is Crystal Dickerson's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Crystal Dickerson was last updated on November 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.

Active since February 18, 2014PECOS Enrolled

5201 GREAT AMERICA PKWY STE 320, SANTA CLARA, CA 95054(323) 205-7088(833) 419-0181 Get Directions Write a Review

NPPES record last updated: November 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 29, 2025, Nov 11, 2025, Jun 27, 2025 and 1 more (4 updates tracked since 2022).

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About Crystal Marie Dickerson NPPES

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

CRYSTAL MARIE DICKERSON (NPI 1871917468) is an individual marriage & family therapist in Santa Clara, California, licensed in California (155533) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1871917468

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameCRYSTAL MARIE DICKERSON

Location Address5201 GREAT AMERICA PKWY STE 320Santa Clara, CA 95054-1140

Mailing Address1501 Moselle CtModesto, CA 95358-5655 · (209) 556-7808

Phone(323) 205-7088

Fax(833) 419-0181

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateFebruary 18, 2014

Last NPPES UpdateNovember 29, 20254 updates tracked since enumeration

NPPES CertifiedNovember 29, 2025

✔ NPI 1871917468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 155533

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

5201 GREAT AMERICA PKWY STE 320, Santa Clara, CA 95054

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Secondary Practice Locations 2

Location 13600 Lime St Ste 711Riverside, CA 92501-2978 · Phone (909) 470-1456

Location 2680 E Colorado BlvdPasadena, CA 91101-6143 · Phone (646) 941-7645 · Fax (929) 596-7897

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Crystal Marie Dickerson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335632850

PECOS Enrollment IDI20251203002531

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. DEBORAH MARIE BOUCHER-CARTER

Marriage & Family Therapist