Individual provider Active NPI

Kirsten Lowry, PH.D.

  • Clinical Psychologist
  • San Luis Obispo, CA
National Provider Identifier
1104123777
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY23890 Issued in CA
Practice address
1985 Johnson Ave
San Luis Obispo, CA 93401-4131
Phone
(805) 602-1062
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY23890 CA Primary

Addresses

Primary practice location

1985 Johnson Ave
San Luis Obispo, CA 93401-4131

Mailing address

PO Box 4524
Paso Robles, CA 93447-4524
Phone (805) 602-1062

Other identifiers 1

IdentifierTypeStateIssuer
ER077AOtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110331000101 CA Practitioner - Clinical Psychologist 7810170156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Nevada School of Medicine, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Paso Robles, CA 93446
Phone (805) 602-1062

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY23890CAMDClinical Psychologist
23890CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kirsten Lowry Psychologist Inc CurrentSince Jul 29, 2014 Accepting new patients

Locations

945 Spring St
Ste 4
Paso Robles, CA 93446
Phone (805) 602-1062

1985 Johnson Ave
Sn Luis Obisp, CA 93401
Phone (800) 460-9219

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1104123777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4524",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934474524",
            "telephone_number": "805-602-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1985 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934014131",
            "telephone_number": "805-602-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWRY",
        "first_name": "KIRSTEN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ER077A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.