Chad E Kiedrowski

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT87428 Issued in CA

Practice address

10776 Fremont St
Yucaipa, CA 92399-9630

Phone

(951) 797-0114

NPI assigned

Nov 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Marriage and Family Therapist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

High Desert Psychological ServicesGroup PAC ID 2860819125, 82 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• High Desert Psychological Services

  • Psychologist
  • Victorville, CA
  • NPI 1104463371

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1457533630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10776 FREMONT ST",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923999630",
            "telephone_number": "951-797-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10776 FREMONT ST",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923999630",
            "telephone_number": "951-797-0114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Orange St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925013613",
            "country_code": "US",
            "telephone_number": "951-955-4545",
            "fax_number": "951-955-2138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIEDROWSKI",
        "first_name": "CHAD",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT87428",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "45168",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Briana Kearns, FNP-C
• Carly A Kemmerer, MS, SLP
• Jereme Kent
• Ayah Khairallah, BA
• Andrew Khong, DPT
• Jean Elizabeth Kielhold, R.D.
• Elizabeth Kiernan
• Gukhyeong Kim
• Jeein Kim
• Mi la Kim, FNP

• Marriage & Family Therapist in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.