Kimberly Brooke Van Den Enden, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 17311 Issued in CA

Practice address

309 Buena Fortuna Cir
Atascadero, CA 93422-8857

Phone

(209) 765-3817

NPI assigned

May 20, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1073748968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 BUENA FORTUNA CIR",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934228857",
            "telephone_number": "209-765-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 BUENA FORTUNA CIR",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934228857",
            "telephone_number": "209-765-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEN ENDEN",
        "first_name": "KIMBERLY",
        "middle_name": "BROOKE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 17311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Louise Tuohey-Mote, FNP
• Jennifer Vacovsky, PSYD
• Emma Grace Valencia, BS
• Joey Valero
• Summer Van Beurden
• Stefan Charles Van Harmelen, D.D.S.
• Stacie Van Scoy
• Rose Marie Vargas
• Lisa Thiel Vasak, M.D.
• Vanessa Haide Vega Razo

• Speech-Language Pathologist in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.