1. Home
  2. Directory
  3. California
  4. Santa Clara
  5. Marriage Family Therapist
  6. NPI Profile

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

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: November 01, 2026.

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

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
Open in Google Maps ↗

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

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

Sud Specialty Group - Ca
0.7 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

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

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
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (323) 205-7088
MR. WILLIAM BRUCE FAMULARO II
Social Worker (Clinical)
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (323) 205-7088
DANIELLA GALAVIZ LCSW
Social Worker (Clinical)
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (323) 205-7088
MS. PRESCILLA DANIELLE JOHN
Psychologist
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (646) 681-7506
JASON NERIO
Marriage & Family Therapist
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (323) 205-7088
CUCUMBER WELLNESS, INC.
Psychiatry & Neurology (Psychiatry)
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (833) 427-3566
KAYLA BRITTNEY SCHELL LISW
Social Worker (Clinical)
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (323) 205-7088
MRS. DIANA BAINBRIDGE CRNP
Nurse Practitioner (Psychiatric/Mental Health)
5201 GREAT AMERICA PKWY STE 320
SANTA CLARA, CA 95054
Santa Clara County (323) 205-7088

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 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.

Where is Crystal Dickerson located?

Crystal Dickerson practices at 5201 Great America Pkwy Ste 320, Santa Clara, CA 95054. The listed phone number is (323) 205-7088.

What is Crystal Dickerson's specialty?

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

Is Crystal Dickerson enrolled in Medicare?

Yes. Crystal Dickerson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Crystal Dickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Crystal Dickerson reassigns Medicare benefits to Sud Specialty Group - Ca (Santa Clara, 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 Crystal Dickerson'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 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 11 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.