Individual provider Active NPI

Kathryn Jean Veyna, NP

  • Family Nurse Practitioner
  • San Luis Obispo, CA
National Provider Identifier
1255374690
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP14520 Issued in CA
Practice address
1304 Ella St Ste a
San Luis Obispo, CA 93401-4165
Phone
(805) 549-9555
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN495632 CA
Physician Assistant 363A00000X PA17233 CA
Family Nurse Practitioner 363LF0000X NP14520 CA Primary

Addresses

Primary practice location

1304 Ella St Ste a
San Luis Obispo, CA 93401-4165

Mailing address

1400 E. Church Street
Attention- Medical Staff Office
Santa Maria, CA 93454
Phone (805) 739-3954

Other identifiers 3

IdentifierTypeStateIssuer
PA17233OtherCADCA- PA LICENSE
14520OtherCANP FURNISHING NUMBER
RN495632OtherCALICENSE NUMBER

Other names 1

  • Kathryn Jean Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140606000913 CA Practitioner - Nurse Practitioner 4486550670

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1400 E Church St
Attention Medical Staff Office
Santa Maria, CA 93454-5906

2625 E Divisadero St
Fresno, CA 93721-1431

5809 200TH St W
Farmington, MN 55024-9807

PO Box
Suite 4659
San Luis Obispo, CA 93403-4659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

State licenses

LicenseStateTypeSpecialty
14520CAMDProfessional Counselor
RN495632CAMDRegistered Nurse
PA17233CAMDPhysician Assistant
NP14520CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Faculty Associates, Inc. Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
California Cancer Associates for Research and Excellence Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kathryn.veyna.1@10606.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1255374690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E. CHURCH STREET",
            "address_2": "ATTENTION- MEDICAL STAFF OFFICE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-739-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 ELLA ST STE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014165",
            "telephone_number": "805-549-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEYNA",
        "first_name": "KATHRYN",
        "middle_name": "JEAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN495632",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17233",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP14520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DCA- PA LICENSE",
            "identifier": "PA17233",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP FURNISHING NUMBER",
            "identifier": "14520",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "RN495632",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SMITH",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.