Provider Demographics
NPI:1356598551
Name:KUYKENDALL, KRISTIN ELIZABETH (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:KUYKENDALL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3709
Mailing Address - Country:US
Mailing Address - Phone:415-920-9984
Mailing Address - Fax:
Practice Address - Street 1:363 JERSEY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3709
Practice Address - Country:US
Practice Address - Phone:415-920-9984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP16345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist