Active NPI
Kindra Nicole Berumen De Dios, PT, DPT
- Physical Therapist
- Santa Clarita, CA
National Provider Identifier
1699010777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 39697
- Practice address
- 28159 Ebb CT
Santa Clarita, CA 91350-1962 - Phone
- (661) 992-8012
- NPI assigned
- Nov 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 39697 | CA | |
| Physical Therapist | 225100000X | 39697 | CA | Primary |
Addresses
Primary practice location
28159 Ebb CT
Santa Clarita, CA 91350-1962
Mailing address
28159 Ebb CT
Santa Clarita, CA 91350-1962
Phone (661) 992-8012
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 |
|---|---|---|---|
| 39697 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1699010777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28159 EBB CT",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913501962",
"telephone_number": "661-992-8012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28159 EBB CT",
"city": "SANTA CLARITA",
"state": "CA",
"postal_code": "913501962",
"telephone_number": "661-992-8012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE DIOS",
"first_name": "KINDRA NICOLE",
"middle_name": "BERUMEN",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-30",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "39697",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "39697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Clarita, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.