Active NPI
Rumicko Kellenberger
- Professional Counselor
- San Jacinto, CA
National Provider Identifier
1093469140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 22176
- Practice address
- 1370 S State St Ste B
San Jacinto, CA 92583-4922 - Phone
- (951) 791-3596
- Fax
- (951) 791-3397
- NPI assigned
- Feb 8, 2022
- Last updated
- Sep 22, 2026
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 22176 | CA | Primary |
Addresses
Primary practice location
1370 S State St Ste B
San Jacinto, CA 92583-4922
Mailing address
4425 Pine White Rd
Hemet, CA 92545-8972
Phone (951) 428-6991
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 |
|---|---|---|---|
| 22176 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790035200000",
"number": "1093469140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4425 PINE WHITE RD",
"city": "HEMET",
"state": "CA",
"postal_code": "925458972",
"telephone_number": "951-428-6991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1370 S STATE ST STE B",
"city": "SAN JACINTO",
"state": "CA",
"postal_code": "925834922",
"telephone_number": "951-791-3596",
"fax_number": "951-791-3397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLENBERGER",
"first_name": "RUMICKO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-08",
"last_updated": "2026-09-22",
"certification_date": "2026-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "22176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jacinto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.