Individual provider Active NPI

Kristen Barnum, PA

  • Physician Assistant
  • Bonita, CA
National Provider Identifier
1720856966
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01741 Issued in RI
Practice address
4358 Bonita Rd Ste 400
Bonita, CA 91902-1421
Phone
(619) 695-1266
NPI assigned
Dec 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA66813 CA
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA01741 RI Primary

Addresses

Primary practice location

4358 Bonita Rd Ste 400
Bonita, CA 91902-1421

Mailing address

4358 Bonita Rd Ste 400
Bonita, CA 91902-1421
Phone (619) 695-1266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, RI, CA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20240904002982 VA Practitioner - Physician Assistant 1951841097 Reassigns benefits to 1 organization
I20250319003119 RI Practitioner - Physician Assistant 1951841097
I20250811003219 CA Practitioner - Physician Assistant 1951841097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855

4358 Bonita Rd
Suite 400
Bonita, CA 91902-1421
Phone 619695126645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA66813CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Velocity Urgent Care, LLC CurrentSince Jun 16, 2024 Accepting new patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients
Southcoast Physicians Group, Inc. PastSince Mar 11, 2025 Accepting new patients

Locations

4374 New Town Ave
Williamsburg, VA 23188
Phone (757) 772-6124

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1720856966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4358 BONITA RD STE 400",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021421",
            "telephone_number": "619-695-1266",
            "fax_number": "858-402-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4358 BONITA RD STE 400",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021421",
            "telephone_number": "619-695-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNUM",
        "first_name": "KRISTEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA66813",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita, CA

Sources for this page

Verify at the official NPI Registry.