Healthcare Provider Details

I. General information

NPI: 1184175317
Provider Name (Legal Business Name): KARA RHYNES B.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 MULBERRY PL
BRENTWOOD CA
94513-6104
US

IV. Provider business mailing address

1134 MULBERRY PL
BRENTWOOD CA
94513-6104
US

V. Phone/Fax

Practice location:
  • Phone: 925-719-5743
  • Fax:
Mailing address:
  • Phone: 925-719-5743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number4109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: