Individual provider Active NPI

Kiera Gran

  • Speech-Language Pathologist
  • San Bernardino, CA
National Provider Identifier
1518676709
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
34297 Issued in CA
Practice address
1760 W 16TH St
San Bernardino, CA 92411-1160
Phone
(909) 473-1200
NPI assigned
Nov 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 34297 CA Primary
Speech-Language Pathologist 235Z00000X SP.15007 OH

Addresses

Primary practice location

1760 W 16TH St
San Bernardino, CA 92411-1160

Mailing address

1690 W Lane Ave Unit 347
Columbus, OH 43221-3967

Other practice location 1

1625 Oak Park Blvd
Pleasant Hill, CA 94523-4487
Phone (925) 935-5222

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

LicenseStateTypeSpecialty
SP.15007OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1518676709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 W LANE AVE UNIT 347",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432213967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 W 16TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924111160",
            "telephone_number": "909-473-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1625 Oak Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Pleasant Hill",
            "state": "CA",
            "postal_code": "945234487",
            "country_code": "US",
            "telephone_number": "925-935-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAN",
        "first_name": "KIERA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "34297",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.15007",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.