Individual provider Active NPI

Kristin R. McNulty, CATC / RAS

  • Addiction (Substance Use Disorder) Counselor
  • Sacramento, CA
National Provider Identifier
1164868840
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
310 Harris Ave Ste a
Sacramento, CA 95838
Phone
(916) 649-6793
NPI assigned
May 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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 Primary

Addresses

Primary practice location

310 Harris Ave Ste a
Sacramento, CA 95838

Mailing address

310 Harris Ave Ste a
Sacramento, CA 95838-3249
Phone (916) 649-6793

Other practice location 1

310 Harris Ave Ste A
Sacramento, CA 95838
Phone (916) 649-6793 ext. 9043

Other practice location 2

9190 Tuolumne Dr
10
Sacramento, CA 95826-2406
Phone (916) 519-2288

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

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1164868840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HARRIS AVE STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958383249",
            "telephone_number": "916-649-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HARRIS AVE STE A",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95838",
            "telephone_number": "916-649-6793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Harris Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "95838",
            "country_code": "US",
            "telephone_number": "916-649-6793 x9043",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9190 Tuolumne Dr",
            "address_2": "10",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958262406",
            "country_code": "US",
            "telephone_number": "916-519-2288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "KRISTIN",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "CATC / RAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "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 Sep 13, 2019; 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.