Individual provider Active NPI

Kathleen L Assaad

  • Peer Specialist
  • Sacramento, CA
National Provider Identifier
1508552878
Registry record updated Mar 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
2750 Sutterville Rd
Sacramento, CA 95820-1024
Phone
(916) 452-3981
NPI assigned
Apr 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X CA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

2750 Sutterville Rd
Sacramento, CA 95820-1024

Mailing address

260 Sun Shower Cir
Sacramento, CA 95823-6730
Phone (916) 826-3998

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

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709424000000",
    "number": "1508552878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 SUN SHOWER CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958236730",
            "telephone_number": "916-826-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 SUTTERVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201024",
            "telephone_number": "916-452-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSAAD",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2024-03-03",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.