DIEDRA Y KINNE (NPI# 1275917379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275917379 |
| Entity Type | Individual |
| Full Name | DIEDRA Y KINNE |
| Practice Address |
240 West Jensen St. Fredonia AZ 86022-0491 |
| Mailing Address |
240 West Jensen St. Fredonia AZ 86022 |
| Practice Telephone | 9289250388 |
| Mailing Telephone | 9289250388 |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 4750887 | AZ | Other Service Providers |
| Street Address |
240 WEST JENSEN ST. |
| City | FREDONIA |
| State | AZ |
| Zip Code | 86022-0491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013516020 | Josey K Morrison | Massage Therapist | 1485 East 3200 South, Cane Beds, AZ 86022 | 2020-10-21 |
| 1023638806 | David Armstrong Lambert | Speech-Language Pathologist | 221 East Hortt Strett, Fredonia, AZ 86022 | 2020-04-21 |
| 1003315151 | Thomas Charles Kinne II | Respite Care | 314 Aspen Street, Fredonia, AZ 86022 | 2018-02-05 |
| 1629339437 | Re-creation Retreat LLC | Substance Abuse Rehabilitation Facility | 455 South Main, Fredonia, AZ 86022 | 2012-06-07 |
| 1659686897 | James Gray Millward | Dentist | 100 E. Wood Hill Rd., Fredonia, AZ 86022 | 2010-08-12 |
| 1518134626 | Deanne Lazenby Peterson | Occupational Therapist | 10 Rosecliff Lane, Cane Beds, AZ 86022 | 2008-05-08 |
| 1811189103 | Fredonia-moccasin Unified School District | Local Education Agency (LEA) | 221 East Hortt Street, Fredonia, AZ 86022 | 2007-08-10 |
| 1265556336 | Guy Ronald Finicum | Counselor | 2800 N. 50 E., Fredonia, AZ 86022 | 2007-03-16 |
| 1144368010 | Randy K Soderquist | Social Worker | 465 South Main, Fredonia, AZ 86022 | 2007-02-02 |
| 1427006469 | William J Trudell | Counselor | 850 E. Hwy 89a, Fredonia, AZ 86022 | 2006-05-04 |
| Find all providers in zip 86022 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083233415 | Shelly C Dillenburg | Peer Specialist | 33 Church St Ste 3, Fredonia, NY 14063-1761 | 2020-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679181457 | Justin David Lee Harvey | Peer Specialist | 1616 E Main St Ste 207a-1, Mesa, AZ 85203-9071 | 2020-07-17 |
| 1689295636 | Native Music Coalition | Peer Specialist | 4814 S Warren Ave, Tucson, AZ 85714-1749 | 2020-04-30 |
| 1063031532 | Grace Irene Tang | Peer Specialist | 3023 N Calle Castellon, Tucson, AZ 85745-9512 | 2020-04-14 |
| 1407493687 | Vincent Merced Flores | Peer Specialist | 1706 E Calle Salamanca, Tucson, AZ 85714-1729 | 2019-12-05 |
| 1043737497 | Penny Pulz Golf LLC | Peer Specialist | 10315 W Wininger Cir Ste B, Sun City, AZ 85351-4758 | 2017-08-26 |
| 1861884157 | Valena F Eisenhart | Peer Specialist | 1745 N Kadota Ave, Casa Grande, AZ 85122-2131 | 2015-02-24 |
| 1578953477 | Vincent Nicasio Jr. | Peer Specialist | 471 N Marshall Loop Rd, Somerton, AZ 85350-6216 | 2015-01-29 |
| 1235737156 | Timothy Chakos-kender | Peer Specialist | 4343 N 16th St, Phoenix, AZ 85016-5338 | 2020-10-13 |
| 1518565696 | Aaron R Fry | Peer Specialist | 4343 N 16th St, Phoenix, AZ 85016-5338 | 2020-10-12 |
| 1508474917 | Chauncey Bradford | Peer Specialist | 1616 E Main St Ste 207a-1, Mesa, AZ 85203-9071 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
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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.