Jennifer Kugel Fritz, PSYD
Individual provider Active NPI Clinical Psychologist · Alpine, CA
NPI 1013071497 · NPPES record last updated Oct 19, 2013
Key facts
- NPI
- 1013071497
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY24350 (CA)
- Practice address
- 1620 Alpine Blvd
Alpine, CA 91901-1102 - Phone
- (619) 445-6200
- Fax
- (619) 320-3347
- NPI assigned
- Dec 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centro de Salud de la Comunidad de San Ysidro,Inc.
Practice addresses (Care Compare)
1620 Alpine Blvd
Suite 110
Alpine, CA 91901-1103
Phone (619) 662-4100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111109000619 | CA | Practitioner - Clinical Psychologist | 0840463709 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY24350 | CA | MD | Clinical Psychologist |
Practice roles (4 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de la Comunidad de San Ysidro Inc | Current |
Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro Inc | Current |
Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients | |
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients |
Locations
1620 Alpine Blvd
Ste 110
Alpine, CA 91901
Phone (760) 350-9725
1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780
1136 D Ave
National City, CA 91950
Phone (619) 336-2300
316 25th St
San Diego, CA 92102
Phone (619) 234-1365
4050 Beyer Blvd
San Ysidro, CA 92173
120 Town Center Pkwy
Santee, CA 92071
Phone (619) 645-0111
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY24350 | CA | Yes |
Addresses
Primary practice location
1620 Alpine Blvd
Alpine, CA 91901-1102
Mailing address
1620 Alpine Blvd
118
Alpine, CA 91901-1102
Phone (619) 445-6200
Other providers in Alpine, CA
- Karen Fisher
- Natalya B Flatley
- Brianna Noelle Follmer
- Jessica Lynne Fonte
- Clinton Robert Friday
- Ashley Fuller
- Fusion Care Group, a Psychological Professional Corporation
- Rene Gaeta
- Corinna Marie Garcia
- Terri L Garcia
All providers in Alpine, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.