Colette Augustina Kavanaugh, L.E.

Primary specialty

Other TechnicianTaxonomy code 247200000X

License

9736 Issued in CA

Practice address

1721 Eastern Ave Ste 2
Sacramento, CA 95864-1745

Phone

(916) 838-8240

NPI assigned

Jun 1, 2022

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

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1245979905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3437 MAUREEN DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213114",
            "telephone_number": "916-838-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 EASTERN AVE STE 2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958641745",
            "telephone_number": "916-838-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "COLETTE",
        "middle_name": "AUGUSTINA",
        "credential": "L.E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2024-04-30",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Other",
            "state": "CA",
            "license": "9736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "colibrielectrology@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1721 Eastern Ave Ste 2",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958641745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zeenat Kausar, BCBA
• Aditya Kaushal
• Harrison Kautoga
• Carson Kautz-Turnbull
• Shari Lynn Kautzky, P.T.
• Marina Bella Kawa
• Arlene Kawada, M.D.
• Jun Kawano
• Gabrielle Kawashima
• David Kawatu, MD

• Other Technician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Other Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.