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

MS. Crystal Lisa Rene de Cotret, MPAP, PA-C

Individual provider Surgical Physician Assistant · NPI 1780982819

MS. Crystal Lisa Rene de Cotret, MPAP, PA-C is a Physician Assistant in Long Beach, California. Graduated from University of Southern California Keck School of Medicine in 2011, 15 years ago. Practices with Providence Medical Foundation, a 1,465-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
15
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3828 Schaufele Ave Ste 340
Long Beach, CA 90808-1793
Phone: (657) 241-9052
Fax: (714) 665-4663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA21595 (CA)

Record details

NPI number1780982819
Entity typeIndividual (Type 1)
GenderFemale
Credentials MPAP , PA-C
Sole proprietorNo
NPI enumeratedMarch 15, 2011
Last updated in NPPESAugust 10, 2022
Certification dateAugust 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Providence Medical Foundation — 1465 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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