Active NPI
Kathleen May Peregoy, RDA
- Dental Assistant
- Red Bluff, CA
National Provider Identifier
1194944090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 39486
- Practice address
- 1425 Montgomery Rd
Red Bluff, CA 96080-4605 - Phone
- (530) 528-8600
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 39486 | CA | Primary |
Addresses
Primary practice location
1425 Montgomery Rd
Red Bluff, CA 96080-4605
Mailing address
9330 San Benito Ave
Gerber, CA 96035-9701
Phone (530) 385-1190
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39486 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194944090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9330 SAN BENITO AVE",
"city": "GERBER",
"state": "CA",
"postal_code": "960359701",
"telephone_number": "530-385-1190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 MONTGOMERY RD",
"city": "RED BLUFF",
"state": "CA",
"postal_code": "960804605",
"telephone_number": "530-528-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREGOY",
"first_name": "KATHLEEN",
"middle_name": "MAY",
"name_prefix": "Miss",
"credential": "RDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "39486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Bluff, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.