NPIMap

Organization Active NPI

Kaiser Permanente

  • Clinical Psychologist
  • San Francisco, CA
National Provider Identifier
1063723948
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 23391 Issued in CA
Legal business name
KAISER PERMANENTE
Practice address
4141 Geary Blvd FL 3
San Francisco, CA 94118-3111
Phone
(415) 833-4092
NPI assigned
Jun 25, 2010
Last updated
Jun 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Authorized official

Name
Dr. Tina K Dietz, PHD
Title
Psychologist
Phone
(415) 833-4092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY 23391 CA Primary

Addresses

Primary practice location

4141 Geary Blvd FL 3
San Francisco, CA 94118-3111

Mailing address

4141 Geary Blvd FL 3
San Francisco, CA 94118-3111
Phone (415) 833-4092

National Provider Directory

National Provider Directory

Locations

4141 Geary Blvd
Fl 3
San Francisco, CA 94118
Phone (415) 833-2292

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1063723948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 GEARY BLVD FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183111",
            "telephone_number": "415-833-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 GEARY BLVD FL 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183111",
            "telephone_number": "415-833-4092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "415-833-4092",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 23391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.