Individual provider Active NPI

Kimberly Fitzgerald, PHD

  • Psychologist
  • San Diego, CA
National Provider Identifier
1033568209
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
31536 Issued in CA
Practice address
9040 Friars Rd
Suite 400
San Diego, CA 92108-5859
Phone
(619) 284-6377
NPI assigned
Jun 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 31536 CA Primary

Addresses

Primary practice location

9040 Friars Rd
Suite 400
San Diego, CA 92108-5859

Mailing address

9040 Friars Rd
Suite 400
San Diego, CA 92108-5859
Phone (619) 284-6377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240122004050 CA Practitioner - Clinical Psychologist 0547612855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alo Ha Psychological Associates IncGroup PAC ID 3476783978, 12 clinicians

Practice addresses (Care Compare)

3517 Camino del Rio S
Suite 302
San Diego, CA 92108-4029
Phone (619) 996-3195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
31536CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Zalewski-Zaragoza, MD, Inc PastSince Dec 4, 2023 Accepting new patients
Mackay Chiropractic Inc PastSince Mar 1, 2006 Accepting new patients
Blake Thompson MD Inc. PastSince Nov 17, 2019 Accepting new patients

Organizations & group practices 4

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": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1033568209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 FRIARS RD",
            "address_2": "SUITE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085859",
            "telephone_number": "619-284-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 FRIARS RD",
            "address_2": "SUITE 400",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085859",
            "telephone_number": "619-284-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "31536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.