Katherine Clair Tristan LCSW PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KATHERINE CLAIR TRISTAN LCSW PC

Practice address

255 N D St Ste 220
San Bernardino, CA 92401-1713

Phone

(951) 823-3498

NPI assigned

Dec 4, 2018

Organization subpart

No

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

Authorized official

Name

Katherine Tristan, LCSW

Title

Clinical Therapist

Phone

(951) 823-3498

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1326518168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N D ST STE 220",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N D ST STE 220",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011713",
            "telephone_number": "951-823-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE CLAIR TRISTAN LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "TRISTAN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "951-823-3498",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IEHP",
            "identifier": "1336575380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kasey David Licensed Clinical Social Worker, Inc.
• Kashamat Group LLC
• Kasiva LLC
• Tony Kastoon, M.D.
• Athena Katerelos
• Sara Katleman, OTR/L
• Katy Chou DDS Inc
• Jamie Kaufman, MS, CCC-SLP
• Harbeen Kaur
• Kiratbir Kaur

• Clinical Social Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.