Active NPI
Kristen La
- Speech-Language Pathologist
- Livermore, CA
National Provider Identifier
1730929431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 35538
- Practice address
- 1263 Hollyhock St
Livermore, CA 94551-1405 - Phone
- (925) 683-9557
- NPI assigned
- May 30, 2024
- 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 | 35538 | CA | Primary |
Addresses
Primary practice location
1263 Hollyhock St
Livermore, CA 94551-1405
Mailing address
1263 Hollyhock St
Livermore, CA 94551-1405
Phone (925) 683-9557
Other names 1
- Kristen Shak
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 |
|---|---|---|---|
| 35538 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1730929431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1263 HOLLYHOCK ST",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945511405",
"telephone_number": "925-683-9557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1263 HOLLYHOCK ST",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945511405",
"telephone_number": "925-683-9557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LA",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-30",
"last_updated": "2024-05-30",
"certification_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "35538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTEN",
"last_name": "SHAK",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.