Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Crystal Clark

Individual provider Community Health Worker · NPI 1154816460

Crystal Clark is a Community Health Worker in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018
Specialties on file
2

Practice location Address checks out

631 Maple Ave
Los Angeles, CA 90014-2211
Phone: (213) 673-3059
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X (CA)
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1154816460
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 28, 2018
Last updated in NPPESMarch 1, 2021
Certification dateMarch 1, 2021

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