Individual provider Active NPI

Vanessa Perry-Kahl, LPN

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Carlsbad, CA
National Provider Identifier
1982067641
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
201400631LPN Issued in OR
Practice address
6185 Paseo del Norte
Ste 150
Carlsbad, CA 92011-1152
Phone
(855) 259-2288
NPI assigned
Mar 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 201400631LPN OR Primary

Addresses

Primary practice location

6185 Paseo del Norte
Ste 150
Carlsbad, CA 92011-1152

Mailing address

6601 NE 78TH CT
Ste a-3
Portland, OR 97218-2823
Phone (503) 252-3949

Other identifiers 1

IdentifierTypeStateIssuer
028382MedicaidOR

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

LicenseStateTypeSpecialty
201400631LPNORMDSubstance Use Disorder Rehabilitation Clinic/Center

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1982067641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 NE 78TH CT",
            "address_2": "STE A-3",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182823",
            "telephone_number": "503-252-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6185 PASEO DEL NORTE",
            "address_2": "STE 150",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111152",
            "telephone_number": "855-259-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY-KAHL",
        "first_name": "VANESSA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OR",
            "license": "201400631LPN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028382",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.