Individual provider Active NPI

Roger Per-Erik Karlsson, PH.D., ABPP

  • Clinical Psychologist
  • Campbell, CA
National Provider Identifier
1013246628
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
21331 Issued in CA
Practice address
51 East Campbell Avenue
Ste 170
Campbell, CA 95008-2001
Phone
(510) 847-5592
NPI assigned
Dec 9, 2009
Last updated
Jun 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X 21331 CA
Psychoanalysis Psychologist 103TP0814X 21331 CA
Clinical Psychologist 103TC0700X 21331 CA Primary

Addresses

Primary practice location

51 East Campbell Avenue
Ste 170
Campbell, CA 95008-2001

Mailing address

51 East Campbell Avenue
Ste 170
Campbell, CA 95008-2001
Phone (510) 847-5592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
21331CAMDPsychoanalysis Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1013246628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 EAST CAMPBELL AVENUE",
            "address_2": "STE 170",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082001",
            "telephone_number": "510-847-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 EAST CAMPBELL AVENUE",
            "address_2": "STE 170",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950082001",
            "telephone_number": "510-847-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARLSSON",
        "first_name": "ROGER",
        "middle_name": "PER-ERIK",
        "name_prefix": "Dr.",
        "credential": "PH.D., ABPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-09",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "21331",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "CA",
            "license": "21331",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "21331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.