Individual provider Active NPI

Kamaljit Kaur Virdi, PH.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1093373482
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY28810 Issued in CA
Practice address
2221 Camino del Rio S Ste 200
San Diego, CA 92108-3609
Phone
(619) 275-2286
NPI assigned
May 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY28810 CA Primary

Addresses

Primary practice location

2221 Camino del Rio S Ste 200
San Diego, CA 92108-3609

Mailing address

2221 Camino del Rio S Ste 200
San Diego, CA 92108-3609

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 26, 2022 through Apr 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY28810CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rochelle Perper, Psychology PC PastSince Feb 13, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1093373482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 CAMINO DEL RIO S STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 CAMINO DEL RIO S STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083609",
            "telephone_number": "619-275-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRDI",
        "first_name": "KAMALJIT",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY28810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.