Kerry King, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

WAIVERED Issued in CA

Practice address

490 N Grape St
Escondido, CA 92025-3079

Phone

(760) 975-9939

Fax

(760) 509-9093

NPI assigned

Apr 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1225251812
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700
  NPD (past)
• Exodus Recovery, Inc.

  • Community/Behavioral Health Agency
  • Vista, CA
  • NPI 1316543754
  NPD (past)

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1043630767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13476",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920393476",
            "telephone_number": "858-663-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 N GRAPE ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253079",
            "telephone_number": "760-975-9939",
            "fax_number": "760-509-9093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "536 W Vista Way Ste A",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920835704",
            "country_code": "US",
            "telephone_number": "760-758-1650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "KERRY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "WAIVERED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uesin Kim
• Venice Kim
• Kimberly Rose Davis MD Inc Apmc
• Kelsie Alexandra Kinden, PSYD
• Brandon King
• Lisa Jean Kinney-Ham, M.D.
• Liora Kirby, PA-C
• Tamara Louise Kirby, LVN
• Emma Kirkman-Liff
• Crystal Kirven

• Psychologist in Escondido, CA
• Providers in Escondido, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.