Individual
CRYSTAL SAMANTHA LOPEZ-MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23701 E EAST FORK RD, AZUSA, CA 91702-1477
(626) 250-3300
(626) 910-1380
Mailing address
23701 E EAST FORK RD, AZUSA, CA 91702-1477
(626) 250-3300
(626) 910-1380
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
CA
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/25/2022
Last updated
04/19/2025
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