Active NPI
Kathleen Hagino, PSYD
- Psychologist
- Los Altos, CA
National Provider Identifier
1083139927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY19528
- Practice address
- 4 Main St Ste 110
Los Altos, CA 94022-2931 - Phone
- (650) 383-7655
- NPI assigned
- Aug 11, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY19528 | CA | Primary |
Addresses
Primary practice location
4 Main St Ste 110
Los Altos, CA 94022-2931
Mailing address
4 Main St Ste 110
Los Altos, CA 94022-2931
Phone (650) 383-7655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2016 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY19528 | CA | MD | Psychologist |
| 19528 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502409600000",
"number": "1083139927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 MAIN ST STE 110",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940222931",
"telephone_number": "650-383-7655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 MAIN ST STE 110",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940222931",
"telephone_number": "650-383-7655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGINO",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-11",
"last_updated": "2017-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY19528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Altos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.