Kirstiana Bandong, CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

36285 Issued in CA

Practice address

2765 Mitchell Dr
Walnut Creek, CA 94598-1601

Phone

(510) 358-1881

NPI assigned

Feb 1, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1366205387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2765 MITCHELL DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945981601",
            "telephone_number": "510-358-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 MITCHELL DR",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945981601",
            "telephone_number": "510-358-1881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2904 Dobson Ct",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945552312",
            "country_code": "US",
            "telephone_number": "510-358-1881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANDONG",
        "first_name": "KIRSTIANA",
        "credential": "CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "36285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Baloyra, D.C.
• Christian A. Balzer, M.D.
• Kimberly Banaga, PHARM D.
• Laura R Banashek, MD
• Yareli Banda
• Jacob Banducci
• Sujay Banerjee, MD
• Hector B Banez
• La Rae Robin Banks, DRPH, MBA-HM
• Ingrid Esmeralda Banos Flores

• Speech-Language Pathologist in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.