Active NPI
Kattya Campbell
- Community Health Worker
- Riverside, CA
National Provider Identifier
1821727876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- MPSS-WVMHZQ
- Practice address
- 3125 Myers St
Riverside, CA 92503-5527 - Phone
- (951) 358-7630
- NPI assigned
- Jun 6, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-WVMHZQ | CA | |
| Community Health Worker | 172V00000X | MPSS-WVMHZQ | CA | Primary |
Addresses
Primary practice location
3125 Myers St
Riverside, CA 92503-5527
Mailing address
3125 Myers St. Entrance 3, Office # 243
Riverside, CA 92503-5527
Phone (951) 358-7630
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175T00000X | Medicaid | CA | |
| 172V00000X | Medicaid | CA |
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 |
|---|---|---|---|
| MPSS-WVMHZQ | CA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1821727876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 MYERS ST. ENTRANCE 3, OFFICE # 243",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035527",
"telephone_number": "951-358-7630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 MYERS ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925035527",
"telephone_number": "951-358-7630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "KATTYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-06",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-WVMHZQ",
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"license": "MPSS-WVMHZQ",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "175T00000X",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172V00000X",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.