Individual provider Active NPI

Andrea Krulac

  • Speech-Language Assistant
  • Redondo Beach, CA
National Provider Identifier
1013128370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
100786 Issued in CA
Practice address
811 N Catalina Ave
200
Redondo Beach, CA 90277-2133
Phone
(310) 798-1914
Fax
(310) 376-2748
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 100786 CA Primary

Addresses

Primary practice location

811 N Catalina Ave
200
Redondo Beach, CA 90277-2133

Mailing address

PO Box 3531
Redondo Beach, CA 90277-1531
Phone (310) 798-1914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100786CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Krulac Medical Inc Past Accepting new patients
Medwest Orthopedics Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013128370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3531",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902771531",
            "telephone_number": "310-798-1914",
            "fax_number": "310-376-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N CATALINA AVE",
            "address_2": "200",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772133",
            "telephone_number": "310-798-1914",
            "fax_number": "310-376-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRULAC",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "100786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.