Kristie M Pan, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-33500 Issued in CA

Practice address

1720 S Amphlett Blvd Ste 110
San Mateo, CA 94402-2710

Phone

(650) 483-9174

NPI assigned

Apr 15, 2019

Sex

Female

Sole proprietor

No

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)

Not 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 and National Provider Directory roles.

• Oo Speech Pathology Ca, P.C.

  • Speech-Language Pathologist
  • San Mateo, CA
  • NPI 1962054015
  NPD (past)

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1609439751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HOLYOKE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941341737",
            "telephone_number": "415-816-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 S AMPHLETT BLVD STE 110",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022710",
            "telephone_number": "650-483-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAN",
        "first_name": "KRISTIE",
        "middle_name": "M",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-18-33500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Ann Palafox
• Adam Paley, MD
• Michelle Palma
• Marcia J Palmer, O.D.
• Gregorio Semilla Palomares Jr.
• Nataliya Panchenko, LCSW
• Perbey Ann Pandac
• Isha Sunil Pandya
• Catherine Pang, MD
• Eva K Pang

• All providers in San Mateo, CA
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2019; 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.