Kaiser Permanente

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

Organization subpart

No

Name

Dr. Tina K Dietz, PHD

Title

Psychologist

Phone

(415) 833-4092

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 25, 2010.

{
    "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": []
}

• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente

• All providers in San Francisco, CA
• Clinical Psychologist in California

• 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.