NPIMap

Organization Active NPI

Kaleidacare Health and Wellness Physician Assistant Inc.

  • Medical Physician Assistant
  • Sacramento, CA
National Provider Identifier
1124988753
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
KALEIDACARE HEALTH AND WELLNESS PHYSICIAN ASSISTANT INC.
Practice address
1401 21St St Ste R
Sacramento, CA 95811-5226
Phone
(559) 417-7575
NPI assigned
Nov 15, 2025
Last updated
Jul 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Authorized official

Name
Kaitlyn Crouch, PA-CNPI 1194316612
Title
President
Phone
(559) 417-7575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

1401 21St St Ste R
Sacramento, CA 95811-5226

Mailing address

1401 21St St Ste R
Sacramento, CA 95811-5226
Phone (480) 570-1137

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1763164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1124988753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 21ST ST STE R",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115226",
            "telephone_number": "480-570-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 21ST ST STE R",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958115226",
            "telephone_number": "559-417-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDACARE HEALTH AND WELLNESS PHYSICIAN ASSISTANT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-15",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "CROUCH",
        "authorized_official_first_name": "KAITLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-417-7575",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.