Xaleese Evelyn Kueppers, CST

Primary specialty

Technician/TechnologistTaxonomy code 156F00000X

Practice address

12265 Ventura Blvd Ste 107
Studio City, CA 91604-2530

Phone

(310) 691-5411

NPI assigned

Oct 17, 2019

Last updated

Oct 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1235771643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23808 BRESCIA DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913543000",
            "telephone_number": "310-691-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12265 VENTURA BLVD STE 107",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916042530",
            "telephone_number": "310-691-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEPPERS",
        "first_name": "XALEESE",
        "middle_name": "EVELYN",
        "credential": "CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SURGICAL TECHNOLOGIST",
            "identifier": "152799",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "23808BRESCIADRValenciaCA91354",
            "affiliation": "N",
            "endpointDescription": "Mailing Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "23808 BRESCIA DR. Valencia, CA 91354",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "MAILING ADDRESS",
            "address_1": "12265 Ventura Blvd Ste 107",
            "city": "Studio City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "916042530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Technician/Technologist in Studio City, CA
• Providers in Studio City, CA by specialty
• Technician/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.