Individual provider Active NPI

Kristin Kiang, OD

  • Optometrist
  • Fremont, CA
National Provider Identifier
1174285464
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
34901 Issued in CA
Practice address
3775 Beacon Ave Ste 140
Fremont, CA 94538-1466
Phone
(510) 791-2233
NPI assigned
Oct 13, 2021
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 34901 CA Primary

Addresses

Primary practice location

3775 Beacon Ave Ste 140
Fremont, CA 94538-1466

Mailing address

101 Mission Cielo Ave
Fremont, CA 94539-3919
Phone (310) 721-3820

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
34901CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1174285464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MISSION CIELO AVE",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945393919",
            "telephone_number": "310-721-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 BEACON AVE STE 140",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381466",
            "telephone_number": "510-791-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIANG",
        "first_name": "KRISTIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; 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.