KAYLENE MEDINA (NPI# 1396343513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396343513 |
| Entity Type | Individual |
| Full Name | KAYLENE MEDINA |
| Practice Address |
1302 Chinook Ln Pueblo CO 81001-1851 |
| Mailing Address |
41 Montebello Rd Ste 204 Pueblo CO 81001-1379 |
| Practice Telephone | 7195452746 |
| Mailing Telephone | 7195452746 |
| Mailing Fax Number | 7195454100 |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
1302 CHINOOK LN |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-1851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053487876 | Vanessa Benavidez | Specialist/Technologist, Other | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2006-11-24 |
| 1194326314 | Roland Valdez | Counselor | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-11-04 |
| 1871191270 | Ariana Gallegos | Registered Nurse | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-10-16 |
| 1083212492 | Nia Gomez | Registered Nurse | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-10-16 |
| 1396342283 | Health Solutions | Clinic/Center | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-10-05 |
| 1922617281 | Barbara Miller | Registered Nurse | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-07-23 |
| 1790394062 | Jo Piano | Registered Nurse | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-07-23 |
| 1427667708 | Reynalda Garoutte | Registered Nurse | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-07-23 |
| 1245848969 | Jennifer Andrews | Registered Nurse | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-07-20 |
| 1922616762 | Emily Fair | Specialist | 1302 Chinook Ln, Pueblo, CO 81001-1851 | 2020-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
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| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467083022 | Stephanie Ortega | Counselor | 1591 Taos Rd, Pueblo, CO 81006-1232 | 2020-01-31 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1689103657 | Jordan Ami Dalton | Counselor | 41 Montebello Rd Ste 221, Pueblo, CO 81001-1366 | 2017-06-05 |
| 1720526742 | Raymond Mizer | Counselor | 4 Redondo Ln, Pueblo, CO 81005-2953 | 2017-02-09 |
| 1801342472 | Cynthia Watson | Counselor | 2429 S. Prairie Avenue, Pueblo, CO 81005 | 2016-09-01 |
| 1417343013 | Denise O'cana | Counselor | 41 Montebello Rd Ste 204, Pueblo, CO 81001-1379 | 2015-04-09 |
| 1932524394 | Karen Khaton | Counselor | 708 Santa Clara Ave, Pueblo, CO 81005-1554 | 2014-02-21 |
| 1447590849 | Teneisha Smith | Counselor | 2109 Chautard Dr, Pueblo, CO 81005-2612 | 2013-02-21 |
| 1871833442 | Josh Aguilar | Counselor | 525 W 9th St, Pueblo, Pueblo, CO 81003-2917 | 2013-02-19 |
| 1851614960 | Danita Jo Johnson | Counselor | 7 Loch Lomond Ln, Pueblo, CO 81001-1729 | 2010-03-03 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.