Active NPI
Jill Kapil, PSY.D.
- Clinical Psychologist
- Santa Ana, CA
National Provider Identifier
1033406723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY28199
- Practice address
- 1530 W. 17TH Street
JSC-110
Santa Ana, CA 92706-3398 - Phone
- (714) 564-6216
- NPI assigned
- Jul 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | PSY28199 | CA | Primary |
Addresses
Primary practice location
1530 W. 17TH Street
JSC-110
Santa Ana, CA 92706-3398
Mailing address
1530 W. 17TH Street
JSC-110
Santa Ana, CA 92706-3398
Phone (714) 564-6216
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033406723 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY28199 | CA | MD | Clinical Psychologist |
| 28199 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1033406723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 W. 17TH STREET",
"address_2": "JSC-110",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927063398",
"telephone_number": "714-564-6216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 W. 17TH STREET",
"address_2": "JSC-110",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927063398",
"telephone_number": "714-564-6216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAPIL",
"first_name": "JILL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-01",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY28199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1033406723",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.