Active NPI
Kathleen O'Malley
- Counselor
- Esparto, CA
National Provider Identifier
1831720259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 111819
- Practice address
- 17317 Fremont St
Esparto, CA 95627-2137 - Phone
- (530) 794-6000
- NPI assigned
- Feb 4, 2020
- Last updated
- Feb 4, 2020
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 111819 | CA | Primary |
Addresses
Primary practice location
17317 Fremont St
Esparto, CA 95627-2137
Mailing address
PO Box 8453
Woodland, CA 95776-8453
Phone (916) 382-2882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 5, 2024 through Mar 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111819 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580774400000",
"number": "1831720259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8453",
"city": "WOODLAND",
"state": "CA",
"postal_code": "957768453",
"telephone_number": "916-382-2882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17317 FREMONT ST",
"city": "ESPARTO",
"state": "CA",
"postal_code": "956272137",
"telephone_number": "530-794-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'MALLEY",
"first_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-04",
"last_updated": "2020-02-04",
"certification_date": "2020-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "111819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Esparto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.