Kristen Ann Ryan, PSY.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4444 Issued in MN

Practice address

190 5TH St E
Ste. 100
Saint Paul, MN 55101-2666

Phone

(651) 389-4677

Fax

(651) 389-4690

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1619066446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 PILLSBURY AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091542",
            "telephone_number": "612-695-0470",
            "fax_number": "612-824-4381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 5TH ST E",
            "address_2": "STE. 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012666",
            "telephone_number": "651-389-4677",
            "fax_number": "651-389-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MN",
            "license": "4444",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Alan Rutzick, D.C.
• RX Team Home Health Care
• Olga Ryabchuck
• Adam Ryan
• Jennifer L Ryan, M.A., A.T.C.
• Lauren Finzer Ryan, LADC, LPCC
• Patrick J Ryan, D.D.S.
• Rachael Girard Ryan, MSW, LICSW
• Robin Lee Ryan, MA LMFT
• Taylor Ryan

• All providers in Saint Paul, MN
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; 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.