Active NPI
Kristin Catherine McConnell
- Occupational Therapist
- Los Angeles, CA
National Provider Identifier
1568081719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 22190
- Practice address
- 1640 Marengo Street Hra Suite 500
Los Angeles, CA 90089-3410 - Phone
- (323) 442-3340
- NPI assigned
- Apr 8, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 22190 | CA | Primary |
Addresses
Primary practice location
1640 Marengo Street Hra Suite 500
Los Angeles, CA 90089-3410
Mailing address
PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-3340
Other practice location 1
6160 Mission Gorge Rd
San Diego, CA 92120-3410
Phone (619) 481-3790
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22190 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620691200000",
"number": "1568081719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900310309",
"telephone_number": "323-442-3340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 MARENGO STREET HRA SUITE 500",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900893410",
"telephone_number": "323-442-3340"
}
],
"practiceLocations": [
{
"address_1": "6160 Mission Gorge Rd",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921203410",
"country_code": "US",
"telephone_number": "619-481-3790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCONNELL",
"first_name": "KRISTIN",
"middle_name": "CATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-08",
"last_updated": "2021-05-11",
"certification_date": "2021-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "22190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.