Individual provider Active NPI

Krista Charlene McDonnal, CATC

  • Addiction (Substance Use Disorder) Counselor
  • El Cajon, CA
National Provider Identifier
1144529082
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
102464 Issued in CA
Practice address
1365 N Johnson Ave
Ste #111
El Cajon, CA 92020-1676
Phone
(619) 440-4801
Fax
(619) 442-1592
NPI assigned
Mar 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 102464 CA Primary

Addresses

Primary practice location

1365 N Johnson Ave
Ste #111
El Cajon, CA 92020-1676

Mailing address

1365 N Johnson Ave
Ste # 111
El Cajon, CA 92020-1676
Phone (619) 440-4801

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

LicenseStateTypeSpecialty
102464CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1144529082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 N JOHNSON AVE",
            "address_2": "STE # 111",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201676",
            "telephone_number": "619-440-4801",
            "fax_number": "619-442-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 N JOHNSON AVE",
            "address_2": "STE #111",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920201676",
            "telephone_number": "619-440-4801",
            "fax_number": "619-442-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNAL",
        "first_name": "KRISTA",
        "middle_name": "CHARLENE",
        "name_prefix": "Mrs.",
        "credential": "CATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "102464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.