Active NPI
Kyle P. Jones, PHD
- Clinical Psychologist
- Costa Mesa, CA
National Provider Identifier
1003650318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY35099
- Practice address
- 1102 Valley Cir
Costa Mesa, CA 92627-3918 - Phone
- (949) 244-3184
- NPI assigned
- Jun 21, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY35099 | CA | Primary |
Addresses
Primary practice location
1102 Valley Cir
Costa Mesa, CA 92627-3918
Mailing address
PO Box 3521
Costa Mesa, CA 92628-3521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY35099 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718928000000",
"number": "1003650318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3521",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926283521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 VALLEY CIR",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926273918",
"telephone_number": "949-244-3184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KYLE",
"middle_name": "P.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY35099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.