Individual provider Active NPI

Kimberly Bastardo, HIS

  • Hearing Instrument Specialist
  • Chico, CA
National Provider Identifier
1558936716
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA8656 Issued in CA
Practice address
2201 Pillsbury Rd Ste 194
Chico, CA 95926-1373
Phone
(530) 343-2350
Fax
(530) 343-2505
NPI assigned
May 20, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA8696 CA
Hearing Instrument Specialist 237700000X HA8656 CA Primary

Addresses

Primary practice location

2201 Pillsbury Rd Ste 194
Chico, CA 95926-1373

Mailing address

2201 Pillsbury Rd Ste 194
Chico, CA 95926-1373
Phone (530) 343-2350

Other identifiers 1

IdentifierTypeStateIssuer
1013239037MedicaidCA

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
HA8656CAMDHearing Instrument Specialist
HA8696CAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1558936716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 PILLSBURY RD STE 194",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261373",
            "telephone_number": "530-343-2350",
            "fax_number": "530-343-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 PILLSBURY RD STE 194",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261373",
            "telephone_number": "530-343-2350",
            "fax_number": "530-343-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTARDO",
        "first_name": "KIMBERLY",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA8696",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA8656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013239037",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.