Kristin Renee Goradietsky

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY36152 Issued in CA

Practice address

2512 Foothill Blvd
La Crescenta, CA 91214-3506

Phone

(626) 214-5092

NPI assigned

Sep 15, 2009

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Katie Enney Psychologist IncGroup PAC ID 0941580930, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Katie Enney Psychologist Inc

  • Psychologist
  • Los Angeles, CA
  • NPI 1245787340
  Medicare reassignment Care Compare group NPD
• Nationwide Medical Group, Inc

  • Community Health Clinic/Center
  • Oxnard, CA
  • NPI 1417004805
  NPD (past)
• Nationwide Medical Group, Inc

  • Community Health Clinic/Center
  • Stockton, CA
  • NPI 1548317951
  NPD (past)

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1427381086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143506",
            "telephone_number": "626-214-5092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 FOOTHILL BLVD",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912143506",
            "telephone_number": "626-214-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORADIETSKY",
        "first_name": "KRISTIN",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY36152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glendale Home Health, Inc.
• GMT Home Health Care, Inc.
• James Alan Godwin, CCC-SLP
• Gold Coast Hospice Inc
• Jerri Goodman, MFT
• Asmik Goukasian, LAC MD
• Grancare LLC (Verdugo Vista Health Care Center)
• Amanda Granier, LCSW
• Amanda Rose Granier
• Robert Sar Greenburg, M.D.

• Clinical Psychologist in La Crescenta, CA
• Providers in La Crescenta, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.