Individual provider Active NPI

Kalia Marie Rothlind, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1801412507
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95020077 Issued in CA
Practice address
1207 E Fruit St
Santa Ana, CA 92701-4206
Phone
(714) 953-9373
NPI assigned
Jun 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95020077 CA Primary

Addresses

Primary practice location

1207 E Fruit St
Santa Ana, CA 92701-4206

Mailing address

1207 E Fruit St
Santa Ana, CA 92701-4206
Phone (714) 953-9373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220425000689 CA Practitioner - Nurse Practitioner 4880081702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Yale University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Berkeley Therapy InstituteGroup PAC ID 2264414283, 13 clinicians

Practice addresses (Care Compare)

1749 Martin Luther King Jr Way
Berkeley, CA 94709-2139
Phone 51084184841130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95020077CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Berkeley Therapy Institute CurrentSince Jan 1, 2024 Accepting new patients

Locations

1749 Martin Luther King Jr Way
Berkeley, CA 94709
Phone (510) 540-1746

Organizations & group practices 1

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": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1801412507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014206",
            "telephone_number": "714-953-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 E FRUIT ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927014206",
            "telephone_number": "714-953-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHLIND",
        "first_name": "KALIA",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95020077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.