Individual provider Active NPI

Kyra Grace McNatt

  • Specialist
  • San Diego, CA
National Provider Identifier
1174218895
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
L9707 Issued in CA
Practice address
3737 Moraga Ave Ste A204
San Diego, CA 92117-5489
Phone
(858) 352-6015
NPI assigned
Apr 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L9707 CA Primary

Addresses

Primary practice location

3737 Moraga Ave Ste A204
San Diego, CA 92117-5489

Mailing address

1533 E Washington Ave Apt 6
El Cajon, CA 92019-2556
Phone (619) 938-5808

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
L9707CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1174218895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 E WASHINGTON AVE APT 6",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920192556",
            "telephone_number": "619-938-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MORAGA AVE STE A204",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175489",
            "telephone_number": "858-352-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNATT",
        "first_name": "KYRA",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "L9707",
            "primary": true
        }
    ],
    "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 Apr 7, 2023; 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.