Individual provider Active NPI

Kristen Aileen Espinoza, P.A.-C

  • Physician Assistant
  • Newport Beach, CA
National Provider Identifier
1073049375
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
NON-LICENSED
Practice address
2115 Sherington PL Apt D314
Newport Beach, CA 92663-6603
Phone
(610) 442-4827
NPI assigned
May 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NON-LICENSED Primary

Addresses

Primary practice location

2115 Sherington PL Apt D314
Newport Beach, CA 92663-6603

Mailing address

2115 Sherington PL Apt D314
Newport Beach, CA 92663-6603
Phone (610) 442-4827

Other names 1

  • Miss Kristen Aileen Kichline Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180104000852 HI Practitioner - Physician Assistant 7810256419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1073049375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 SHERINGTON PL APT D314",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926636603",
            "telephone_number": "610-442-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 SHERINGTON PL APT D314",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926636603",
            "telephone_number": "610-442-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOZA",
        "first_name": "KRISTEN",
        "middle_name": "AILEEN",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "NON-LICENSED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "KICHLINE",
            "middle_name": "AILEEN",
            "prefix": "MISS",
            "credential": "P.A.-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.