Active NPI
Kristina Louise Sisco
- Counselor
- Lake Elsinore, CA
National Provider Identifier
1497147516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 1806
- Practice address
- 224 W Graham Ave
Lake Elsinore, CA 92530-3740 - Phone
- (951) 318-1351
- Fax
- (866) 340-6736
- NPI assigned
- Feb 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1806 | CA | Primary |
Addresses
Primary practice location
224 W Graham Ave
Lake Elsinore, CA 92530-3740
Mailing address
29163 Sundial Cir
Menifee, CA 92584-7362
Phone (858) 829-9838
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1806 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424908800000",
"number": "1497147516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29163 SUNDIAL CIR",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925847362",
"telephone_number": "858-829-9838",
"fax_number": "951-827-3202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 W GRAHAM AVE",
"city": "LAKE ELSINORE",
"state": "CA",
"postal_code": "925303740",
"telephone_number": "951-318-1351",
"fax_number": "866-340-6736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISCO",
"first_name": "KRISTINA",
"middle_name": "LOUISE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-26",
"last_updated": "2015-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "1806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Elsinore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.