Active NPI
Kristin Nicole Warren, M.S. CCC-SLP
- Speech-Language Pathologist
- Ontario, CA
National Provider Identifier
1780019554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 19160
- Practice address
- 4100 Jurupa St
Suite #108
Ontario, CA 91761-1420 - Phone
- (909) 390-1313
- NPI assigned
- Sep 11, 2013
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 19160 | CA | Primary |
Addresses
Primary practice location
4100 Jurupa St
Suite #108
Ontario, CA 91761-1420
Mailing address
4100 Jurupa St
Suite #108
Ontario, CA 91761-1420
Phone (909) 390-1313
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336
Organizations & group practices 3
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.
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- Tacoma, WA
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-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
- Diagnostic Radiology Physician
- Spokane, WA
- NPI 1679042188
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378857600000",
"number": "1780019554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 JURUPA ST",
"address_2": "SUITE #108",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917611420",
"telephone_number": "909-390-1313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 JURUPA ST",
"address_2": "SUITE #108",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917611420",
"telephone_number": "909-390-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARREN",
"first_name": "KRISTIN",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-11",
"last_updated": "2013-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "19160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.