NPIMap

Organization Active NPI

Regents of University of California

  • Clinical Child & Adolescent Psychologist
  • Irvine, CA
National Provider Identifier
1003001009
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PSY12351 Issued in CA
Legal business name
REGENTS OF UNIVERSITY OF CALIFORNIA
Practice address
19262 Jamboree Rd
Irvine, CA 92612-2502
Phone
(949) 824-2343
Fax
(949) 824-8737
NPI assigned
Sep 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Prof. Ronald A Kotkin
Title
Clinical Professor
Phone
(949) 824-6292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC2200X PSY12351 CA Primary

Addresses

Primary practice location

19262 Jamboree Rd
Irvine, CA 92612-2502

Mailing address

19262 Jamboree Rd
Irvine, CA 92612-2502
Phone (949) 824-2343

National Provider Directory

National Provider Directory
Tax ID family
Regents of the University of California42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1003001009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19262 JAMBOREE RD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122502",
            "telephone_number": "949-824-2343",
            "fax_number": "949-824-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19262 JAMBOREE RD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122502",
            "telephone_number": "949-824-2343",
            "fax_number": "949-824-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF UNIVERSITY OF CALIFORNIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "KOTKIN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINICAL PROFESSOR",
        "authorized_official_telephone_number": "949-824-6292",
        "authorized_official_name_prefix": "Prof."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY12351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.