KELLY GRUNDSTROM NPI 1902438211

NPI Information

NPI: 1902438211
Provider Name: KELLY GRUNDSTROM
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address: 22283 MAIN ST
HAYWARD, CA
ZIP 94541
Phone: (800) 249-4961

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NPI Details

Kelly Grundstrom is a student in an organized health care education training program in Hayward, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Kelly Grundstrom NPI is 1902438211. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

22283 MAIN ST
HAYWARD, CA
ZIP 94541-004
Phone: (800) 249-4961

The enumeration date for this NPI number is 2/5/2020 and was last updated on 5/6/2024.

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	Primary
1	106S00000X	Behavior Technician	No
2	171M00000X	Case Manager/Care Coordinator	No
3	390200000X	Student in an Organized Health Care Education/Training Program	Yes

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: 3/30/2025

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