Individual provider Active NPI

Kathleen Marie Kronenwetter, MA CCC SLP

  • Speech-Language Pathologist
  • Sunnyvale, CA
National Provider Identifier
1992995823
Registry record updated Mar 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 9077 Issued in CA
Practice address
809 Duncardine Way
Sunnyvale, CA 94087
Phone
(408) 394-0638
Fax
(408) 749-9828
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP 9077 CA Primary
Speech-Language Pathologist 235Z00000X 5088 NM

Addresses

Primary practice location

809 Duncardine Way
Sunnyvale, CA 94087

Mailing address

809 Duncardine Way
Sunnyvale, CA 94087
Phone (408) 394-0638

Other names 1

  • Mrs. Kathleen Marie Carlson Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP 9077CAMDSpeech-Language Pathologist
5088NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen M Kronenwetter Speech-Language Pathologist Past Accepting new patients

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1992995823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 DUNCARDINE WAY",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "94087",
            "telephone_number": "408-394-0638",
            "fax_number": "408-749-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 DUNCARDINE WAY",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "94087",
            "telephone_number": "408-394-0638",
            "fax_number": "408-749-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONENWETTER",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MA CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 9077",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "5088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "CARLSON",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.