Active NPI
Kathleen Kang
- Speech-Language Pathologist
- Los Angeles, CA
National Provider Identifier
1629435805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP 19989
- Practice address
- 5601 W Olympic Blvd
101
Los Angeles, CA 90036-4855 - Phone
- (310) 748-1146
- NPI assigned
- Jan 19, 2016
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP 19989 | CA | Primary |
Addresses
Primary practice location
5601 W Olympic Blvd
101
Los Angeles, CA 90036-4855
Mailing address
5601 W Olympic Blvd
Unit 101
Los Angeles, CA 90036-4855
Phone (310) 748-1146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A3152471 | Other | CA | DRIVER LICENSE # |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 19989 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453161600000",
"number": "1629435805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5601 W OLYMPIC BLVD",
"address_2": "UNIT 101",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900364855",
"telephone_number": "310-748-1146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 W OLYMPIC BLVD",
"address_2": "101",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900364855",
"telephone_number": "310-748-1146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-19",
"last_updated": "2016-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "SP 19989",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER LICENSE #",
"identifier": "A3152471",
"state": "CA"
}
],
"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 Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.