Dr. Kim Sage Psychology, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29089 Issued in CA

Legal business name

DR. KIM SAGE PSYCHOLOGY, INC.

Practice address

1151 Dove St Ste 202
Newport Beach, CA 92660-2853

Phone

(949) 899-5787

NPI assigned

Oct 2, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kim A Sage, PSY D. #29089

Title

President

Phone

(949) 899-5787

Specialties & licenses 7

Addresses

Locations

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506902400000",
    "number": "1043720261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 202",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 DOVE ST STE 202",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602853",
            "telephone_number": "949-899-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KIM SAGE PSYCHOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-02",
        "last_updated": "2017-10-02",
        "status": "A",
        "authorized_official_last_name": "SAGE",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-899-5787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY D. #29089"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "29089",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "29089",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "29089",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29089",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "29089",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "29089",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "29089",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; 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.