Individual provider Active NPI

Kristine Marie Rounseville

  • Addiction (Substance Use Disorder) Counselor
  • Diamond Springs, CA
National Provider Identifier
1205717550
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
22477 Issued in CA
Practice address
484 Pleasant Valley Rd 4
Diamond Springs, CA 95684
Phone
(530) 344-7633
NPI assigned
Sep 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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 22477 CA Primary

Addresses

Primary practice location

484 Pleasant Valley Rd 4
Diamond Springs, CA 95684

Mailing address

3840 Market CT Apt 28
Shingle Springs, CA 95682-7222
Phone (530) 807-8687

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": "1757548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1205717550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 MARKET CT APT 28",
            "city": "SHINGLE SPRINGS",
            "state": "CA",
            "postal_code": "956827222",
            "telephone_number": "530-807-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 PLEASANT VALLEY RD 4",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "95684",
            "telephone_number": "530-344-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUNSEVILLE",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-11",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "22477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.