KRISTINE MAE FADDISSTUART NPI 1891635520

NPI Information

  • NPI: 1891635520
  • Provider Name: KRISTINE MAE FADDISSTUART
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Individual
  • Address: 590 TOYANZA DRIVE
    SAN ANDREAS, CA
    ZIP 95249
  • Phone: (209) 754-6562

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NPI Details

Kristine Mae Faddisstuart is a peer specialist in San Andreas, CA. The provider is 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. Kristine Mae Faddisstuart NPI is 1891635520. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

590 TOYANZA DRIVE
SAN ANDREAS, CA
ZIP 95249-713
Phone: (209) 754-6562

The enumeration date for this NPI number is 3/31/2026 and was last updated on 3/31/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1175T00000XPeer SpecialistMPSS-RMODKGCALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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