Kristin Canedo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10290 Issued in CA

Practice address

19712 Macarthur Blvd Ste 110
Irvine, CA 92612-2407

Phone

(949) 409-5755

NPI assigned

Oct 21, 2019

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1639712821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 ROCHESTER ST UNIT B",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926273009",
            "telephone_number": "504-982-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19712 MACARTHUR BLVD STE 110",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122407",
            "telephone_number": "949-409-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANEDO",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "10290",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "5819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahiline Campos
• Kassandra Campos
• Nadia S Campos
• Peter D. Cancellier, D.D.S.
• Cancer Center Imaging Inc.
• Denise Canellos, MS, CNS
• Bianca Cannavo, MCD-CCC-SLP
• Julie Lynn Canning, RDH
• Russell Wayne Cannon, D.D.S.
• Tatiana Cannon

• Mental Health Counselor in Irvine, CA
• Providers in Irvine, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.