Daryl John Kallenbach, CNA

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

CNA1000021924 Issued in AZ

Practice address

3465 Thunderbird LN
Lake Havasu City, AZ 86406-5556

Phone

(928) 706-5851

NPI assigned

Dec 21, 2012

Sex

Male

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1356048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1619213576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 BEEFEATER DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864041953",
            "telephone_number": "928-706-5851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 THUNDERBIRD LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864065556",
            "telephone_number": "928-706-5851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLENBACH",
        "first_name": "DARYL",
        "middle_name": "JOHN",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-21",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "AZ",
            "license": "CNA1000021924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Sudkamp Jones
• Joseph R Majerus DC
• Just for Kids Dentistry Lake Havasu
• Jennifer Kaley
• Gene Kalin, M.D.
• Jamie N Kamon-Brancazio, PT, DPT
• Carrie Jean Kane, LPC
• Mirta I Kaperonis, LCSW
• Vasilios W Kaperonis, M.D.
• Katalin H Boleratzky MD Inc

• Home Health Aide in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Home Health Aide in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.