Katie Lynn Vazquez, CPSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

BKITYVZOJMUFESPN Issued in CA

Practice address

2085 Rustin Ave
Riverside, CA 92507-2498

Phone

(951) 955-7163

NPI assigned

Aug 24, 2022

Last updated

Jul 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Katie Lynn Nye Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1417676255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 W BLAINE ST APT 13",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925073699",
            "telephone_number": "951-452-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072498",
            "telephone_number": "951-955-7163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8605 Janet Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925039212",
            "country_code": "US",
            "telephone_number": "951-426-6774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "KATIE",
        "middle_name": "LYNN",
        "credential": "CPSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": "BKITYVZOJMUFESPN",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "NYE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gustavo Vazquez
• Joaquin Vazquez
• Juan Carlos Vazquez, D.C.
• Julia Vazquez
• Karina Vazquez
• Michelle Vazquez
• Noemi Fabiola Vazquez, MD
• Norma Vazquez, D.D.S.
• Veola E. Vazquez, PHD
• Vicente Vazquez, MD

• Peer Specialist in Riverside, CA
• Providers in Riverside, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.