Individual provider Active NPI

Kristin Kay Guziewicz, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Palm Desert, CA
National Provider Identifier
1063001402
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30867 Issued in CA
Practice address
75100 Mediterranean
Palm Desert, CA 92211-9069
Phone
(760) 837-0033
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 4796-154 WI
Speech-Language Pathologist 235Z00000X 30867 CA Primary

Addresses

Primary practice location

75100 Mediterranean
Palm Desert, CA 92211-9069

Mailing address

1301 E Albion St Apt 5
Milwaukee, WI 53202-2223
Phone (414) 514-2389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210505002833 CA Practitioner - Qualified Speech Language Pathologist 4486063302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4796-154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Easy Speech Pathology, Inc. CurrentSince May 3, 2021 Accepting new patients

Locations

1007 E Cooley Dr
Ste 107
Colton, CA 92324
Phone (760) 837-0033

75100 Mediterranean
Palm Desert, CA 92211
Phone (760) 340-9832

Organizations & group practices 1

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": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1063001402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E ALBION ST APT 5",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022223",
            "telephone_number": "414-514-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75100 MEDITERRANEAN",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922119069",
            "telephone_number": "760-837-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZIEWICZ",
        "first_name": "KRISTIN",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4796-154",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "30867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.