Active NPI
Kristin L Gentry, MSW
- Clinical Social Worker
- Chico, CA
National Provider Identifier
1760959043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- ASW85591
- Practice address
- 130 Yellowstone Dr Ste 110
Chico, CA 95973-5884 - Phone
- (530) 879-5991
- NPI assigned
- Oct 25, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW85591 | CA | Primary |
Addresses
Primary practice location
130 Yellowstone Dr Ste 110
Chico, CA 95973-5884
Mailing address
1058 Poplar St
Chico, CA 95928-5837
Phone (909) 569-4131
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 |
|---|---|---|---|
| ASW85591 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540425600000",
"number": "1760959043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1058 POPLAR ST",
"city": "CHICO",
"state": "CA",
"postal_code": "959285837",
"telephone_number": "909-569-4131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 YELLOWSTONE DR STE 110",
"city": "CHICO",
"state": "CA",
"postal_code": "959735884",
"telephone_number": "530-879-5991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTRY",
"first_name": "KRISTIN",
"middle_name": "L",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-25",
"last_updated": "2018-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW85591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.