Individual provider Active NPI

Kristina Dino

  • Family Nurse Practitioner
  • Agoura Hills, CA
National Provider Identifier
1336952589
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95025367 Issued in CA
Practice address
30497 Canwood St Ste 200
Agoura Hills, CA 91301-4330
Phone
(818) 206-3066
NPI assigned
Jan 30, 2025
Last updated
Jan 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95025367 CA
Family Nurse Practitioner 363LF0000X 95025367 CA Primary

Addresses

Primary practice location

30497 Canwood St Ste 200
Agoura Hills, CA 91301-4330

Mailing address

685 Talbert Ave
Simi Valley, CA 93065-5253
Phone (805) 418-0476

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
I20251117001036 CA Practitioner - Nurse Practitioner 9032600168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Psychological Services IncGroup PAC ID 6507019379, 16 clinicians

Practice addresses (Care Compare)

30495 Canwood St
Suite 101
Agoura Hills, CA 91301-4331
Phone (818) 707-7366

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95025367CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael B Rankin MD Inc. CurrentSince Feb 2, 2025 Accepting new patients
Family Psychological Services Inc CurrentSince Oct 1, 2025 Accepting new patients

Locations

30495 Canwood St
Ste 101
Agoura Hills, CA 91301
Phone (818) 707-7366

30497 Canwood St
Ste 200
Agoura Hills, CA 91301
Phone (818) 206-3066

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1336952589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 TALBERT AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655253",
            "telephone_number": "805-418-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30497 CANWOOD ST STE 200",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014330",
            "telephone_number": "818-206-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINO",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95025367",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95025367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agoura Hills, CA

Sources for this page

Verify at the official NPI Registry.