Cassandra R Colvin, RADT-1

Primary specialty

Attendant Care ProviderTaxonomy code 3747A0650X

Practice address

11224 Huntingride Cir
Santee, CA 92071-4732

Phone

(619) 396-8919

NPI assigned

Aug 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Stepping Stone of San Diego, Inc.

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1013045905
  NPD (past)

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1013499771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3767 CENTRAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921052506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11224 HUNTINGRIDE CIR",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920714732",
            "telephone_number": "619-396-8919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3340 Kemper St Ste 103",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921104907",
            "country_code": "US",
            "telephone_number": "571-249-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "CASSANDRA",
        "middle_name": "R",
        "credential": "RADT-1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "D3960130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coast Medical Transport, Inc
• Cohen Chiropractic Inc
• Lance Havens Cohen, D.C.
• Stacey L. Coleman, D.O.
• Andrew Brady Colley, RN
• William Gerard Conroy
• Kemoni Elexis Copeland
• David Algie Corbin, MD
• Erin Dwyer Cormier, OTR/L, CHT
• Phillip Corona, RD

• Attendant Care Provider in Santee, CA
• Providers in Santee, CA by specialty
• Attendant Care Provider in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2020; 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.