Individual provider Active NPI

Rebecca Iza Katz, MD

  • Child & Adolescent Psychiatry Physician
  • Carmel, CA
National Provider Identifier
1093245250
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A183454 Issued in CA
Practice address
3771 Rio Rd Ste 111
Carmel, CA 93923-8671
Phone
(831) 293-7300
Fax
(940) 301-3944
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X DR.0064878 CO
Student in an Organized Health Care Education/Training Program 390200000X MT214439 PA
Child & Adolescent Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0804X A183454 CA Primary

Addresses

Primary practice location

3771 Rio Rd Ste 111
Carmel, CA 93923-8671

Mailing address

3771 Rio Rd Ste 111
Carmel, CA 93923-8671
Phone (831) 293-7300

Other practice location 1

13123 E 16th Ave
Aurora, CO 80045-7106
Phone (720) 777-4524

Other practice location 2

5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-9105

Other identifiers 1

IdentifierTypeStateIssuer
MT214439OtherPAPENNSYLVANIA STATE BOARD OF MEDICINE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 4, 2024 through Sep 4, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A183454CAMDChild & Adolescent Psychiatry Physician
MT214439PAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1093245250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 RIO RD STE 111",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939238671",
            "telephone_number": "831-293-7300",
            "fax_number": "940-301-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 RIO RD STE 111",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939238671",
            "telephone_number": "831-293-7300",
            "fax_number": "940-301-3944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13123 E 16th Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800457106",
            "country_code": "US",
            "telephone_number": "720-777-4524",
            "fax_number": "720-777-7309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Old York Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191413018",
            "country_code": "US",
            "telephone_number": "215-456-9105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATZ",
        "first_name": "REBECCA",
        "middle_name": "IZA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "DR.0064878",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT214439",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A183454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF MEDICINE",
            "identifier": "MT214439",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, CA

Sources for this page

Verify at the official NPI Registry.