Active NPI
Kyle Vang
- Speech-Language Pathologist
- Stockton, CA
National Provider Identifier
1972167831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 28295
- Practice address
- 442 E Hampton St
Stockton, CA 95204-5519 - Phone
- (209) 466-0456
- NPI assigned
- Apr 26, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 28295 | CA | Primary |
Addresses
Primary practice location
442 E Hampton St
Stockton, CA 95204-5519
Mailing address
8625 Hastings CT
Stockton, CA 95210-2049
Phone (209) 271-7501
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 |
|---|---|---|---|
| 28295 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556236800000",
"number": "1972167831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8625 HASTINGS CT",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952102049",
"telephone_number": "209-271-7501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "442 E HAMPTON ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952045519",
"telephone_number": "209-466-0456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "KYLE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-26",
"last_updated": "2019-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "28295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.