Kate Ann Phillips, CADC1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

040736 Issued in OR

Practice address

3340 Kemper St
San Diego, CA 92110-4906

Phone

(619) 523-8121

Fax

(619) 523-8742

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Kathleen Ann Phillips Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1093852261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 KEMPER ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104906",
            "telephone_number": "619-523-8121",
            "fax_number": "619-523-8742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 KEMPER ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104906",
            "telephone_number": "619-523-8121",
            "fax_number": "619-523-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KATE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CADC1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "040736",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OR",
            "license": "040736",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADCII",
            "identifier": "A6520711",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CADC",
            "identifier": "040736",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "PHILLIPS",
            "middle_name": "ANN",
            "credential": "CADCII",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph Douglas Phillips, DDS
• Joshua C Phillips
• Judy N Phillips, PHD
• Julie M. Phillips, MD
• Kaori Sarah Phillips, RN, BSN
• Keeley Isabella Phillips, MD
• Kiana Phillips
• Lexie Jo Phillips, FNP
• Lindsay Phillips
• Martin Ian Phillips

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.