Individual provider Active NPI

Robert M Katnik

  • Clinical Psychologist
  • La Mesa, CA
National Provider Identifier
1013254713
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSB37261 Issued in CA
Practice address
4700 Spring St
#220
La Mesa, CA 91942-0263
Phone
(760) 730-4540
Fax
(619) 667-0815
NPI assigned
Jan 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSB37261 CA Primary

Addresses

Primary practice location

4700 Spring St
#220
La Mesa, CA 91942-0263

Mailing address

PO Box 609001
San Diego, CA 92160-9001
Phone (619) 528-4600

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

State licenses

LicenseStateTypeSpecialty
PSB37261CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Centers at San Diego, Inc. Med GRP Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1013254713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921609001",
            "telephone_number": "619-528-4600",
            "fax_number": "619-528-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SPRING ST",
            "address_2": "#220",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420263",
            "telephone_number": "760-730-4540",
            "fax_number": "619-667-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATNIK",
        "first_name": "ROBERT",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB37261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.