Active NPI
Kristina Horak
- Case Management Agency
- San Luis Obispo, CA
National Provider Identifier
1093280752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- License
- 571385
- Practice address
- 2191 Johnson Ave
San Luis Obispo, CA 93401-4534 - Phone
- (805) 237-3056
- NPI assigned
- Oct 9, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 571385 | CA | Primary |
Addresses
Primary practice location
2191 Johnson Ave
San Luis Obispo, CA 93401-4534
Mailing address
2191 Johnson Ave
San Luis Obispo, CA 93401-4534
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
| License | State | Type | Specialty |
|---|---|---|---|
| 571385 | CA | MD | Case Management Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1093280752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2191 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2191 JOHNSON AVE",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934014534",
"telephone_number": "805-237-3056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORAK",
"first_name": "KRISTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-09",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "CA",
"license": "571385",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.