Individual provider Active NPI

Katherine Yarborough, DO

  • Psychiatry Physician
  • Santa Cruz, CA
National Provider Identifier
1043304983
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A4968 Issued in CA
Practice address
1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone
(831) 454-4170
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A4968 CA Primary

Addresses

Primary practice location

1080 Emeline Ave
Santa Cruz, CA 95060-1966

Mailing address

1400 Emeline Ave
Santa Cruz, CA 95060-1976
Phone (831) 454-4170

Other identifiers 5

IdentifierTypeStateIssuer
FHC 70042FOtherCASANTA CRUZ COUNTY MEDI-CAL GROUP#
ZZZ91892ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP PTAN#
FHC 70044FOtherCASANTA CRUZ COUNTY MEDI-CAL GROUP#
ZZZ91891ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP PTAN#
ZZZ92069ZOtherCASANTA CRUZ COUNTY MEDICARE GROUP PTAN#

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831001321 CA Practitioner - Psychiatry 8628384096 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A4968CAMDPsychiatry Physician
4968CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Luis Obispo Current Accepting new patients
County of San Diego CurrentSince Feb 1, 2023 Accepting new patients
County of San Diego Current Accepting new patients
County of San Diego CurrentSince Feb 1, 2023 Accepting new patients
County of Santa Cruz Past Accepting new patients
Puentes Al Sur Past Accepting new patients
County of Santa Cruz Past Accepting new patients

Locations

1000 Broadway
Ste 210
El Cajon, CA 92021
Phone (619) 401-5500

3853 Rosecrans St
San Diego, CA 92110
Phone (619) 615-0439

3177 Ocean View Blvd
San Diego, CA 92113
Phone (619) 231-9300

1250 Morena Blvd
San Diego, CA 92110
Phone (619) 692-8715

2178 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (805) 781-4711

Organizations & group practices 8

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1043304983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601976",
            "telephone_number": "831-454-4170",
            "fax_number": "831-454-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARBOROUGH",
        "first_name": "KATHERINE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A4968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDI-CAL GROUP#",
            "identifier": "FHC 70042F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91892Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDI-CAL GROUP#",
            "identifier": "FHC 70044F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ91891Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANTA CRUZ COUNTY MEDICARE GROUP PTAN#",
            "identifier": "ZZZ92069Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.