Active NPI
Kirsten M Yergensen, PPS
- School Psychologist
- Yreka, CA
National Provider Identifier
1073308110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 220187635
- Practice address
- 609 S Gold St
Yreka, CA 96097-3110 - Phone
- (530) 331-9711
- NPI assigned
- Apr 10, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 220187635 | CA | Primary |
Addresses
Primary practice location
609 S Gold St
Yreka, CA 96097-3110
Mailing address
310 Orem St
Mount Shasta, CA 96067-2426
Phone (707) 599-8707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220187635 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744243200000",
"number": "1073308110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 OREM ST",
"city": "MOUNT SHASTA",
"state": "CA",
"postal_code": "960672426",
"telephone_number": "707-599-8707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 S GOLD ST",
"city": "YREKA",
"state": "CA",
"postal_code": "960973110",
"telephone_number": "530-331-9711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YERGENSEN",
"first_name": "KIRSTEN",
"middle_name": "M",
"credential": "PPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-10",
"last_updated": "2025-04-10",
"certification_date": "2025-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "220187635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yreka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.