Kristin Green

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

25544 Issued in CA

Practice address

695 Town Center Dr Ste 700
Costa Mesa, CA 92626

Phone

(949) 662-3900

Fax

(949) 431-0045

NPI assigned

Nov 16, 2015

Last updated

Jul 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kristin Green

  dba CA Speech Therapy

  • Speech-Language Pathologist
  • Costa Mesa, CA
  • NPI 1386157501
  NPD (past) Authorized official

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

{
    "created_epoch": "1447632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1568836450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 TOWN CENTER DR STE 700",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267187",
            "telephone_number": "949-662-3900",
            "fax_number": "949-431-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 TOWN CENTER DR STE 700",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "949-662-3900",
            "fax_number": "949-431-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-16",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "25544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Alexis Greaves
• Grecian Chiropractic and Wellness
• Genevieve Greco
• Chanel Green, PA-C
• Jordan Green, OD
• Makyda J Green
• Mylezia Green
• Rebekah Green
• Shannon Green, MFT
• Adam Emmanuel Greenberg

• Speech-Language Pathologist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.