Active NPI
Kristine Noelle Anderson, MSW
- Behavior Technician
- San Diego, CA
National Provider Identifier
1124375795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5333 Mission Center Rd Ste 110
San Diego, CA 92108-1347 - Phone
- (619) 278-0884
- NPI assigned
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary | ||
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
5333 Mission Center Rd Ste 110
San Diego, CA 92108-1347
Mailing address
16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417
Phone (949) 833-2237
Other practice location 1
3800 Coolidge Ave
Oakland, CA 94602-3311
Phone (510) 482-2244
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aces 2020, LLC | Current | Accepting new patients |
Locations
16782 Von Karman Ave
Ste 11
Irvine, CA 92606
Phone (619) 550-6368
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.
-
- Behavior Analyst
- San Diego, CA
- NPI 1467520452
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1124375795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16782 VON KARMAN AVE STE 11",
"city": "IRVINE",
"state": "CA",
"postal_code": "926062417",
"telephone_number": "949-833-2237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5333 MISSION CENTER RD STE 110",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921081347",
"telephone_number": "619-278-0884"
}
],
"practiceLocations": [
{
"address_1": "3800 Coolidge Ave",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946023311",
"country_code": "US",
"telephone_number": "510-482-2244",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSON",
"first_name": "KRISTINE",
"middle_name": "NOELLE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-13",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.