Individual provider Active NPI

Kathi Jones-Lorenz, PH.D.

  • Clinical Psychologist
  • Roseville, CA
National Provider Identifier
1063538254
Registry record updated Jan 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13218 Issued in CA
Practice address
1891 E Roseville Pkwy
Suite 120
Roseville, CA 95661-7973
Phone
(916) 774-6000
Fax
(916) 774-6018
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY13218 CA Primary

Addresses

Primary practice location

1891 E Roseville Pkwy
Suite 120
Roseville, CA 95661-7973

Mailing address

1891 E Roseville Pkwy
Suite 120
Roseville, CA 95661-7973
Phone (916) 774-6000

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
I20040521000500 CA Practitioner - Clinical Psychologist 0446241004 Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1891 E Roseville Pkwy
Roseville, CA 95661-7974
Phone (916) 774-6000

1891 E Roseville Pkwy
Suite 120
Roseville, CA 95661-7976

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY13218CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388534400000",
    "number": "1063538254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 E ROSEVILLE PKWY",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617973",
            "telephone_number": "916-774-6000",
            "fax_number": "916-774-6018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 E ROSEVILLE PKWY",
            "address_2": "SUITE 120",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617973",
            "telephone_number": "916-774-6000",
            "fax_number": "916-774-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES-LORENZ",
        "first_name": "KATHI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2014-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.