Organization Active NPI

Paradigm Psychology, P.C.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1114702693
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PARADIGM PSYCHOLOGY, P.C.
Practice address
4640 Cass St Unit 90924
San Diego, CA 92169-7118
Phone
(619) 940-4345
NPI assigned
Aug 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Kayla Bunderson, PSYDNPI 1366951386
Title
PSYD
Phone
(619) 940-4345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

4640 Cass St Unit 90924
San Diego, CA 92169-7118

Mailing address

4640 Cass St Unit 90924
San Diego, CA 92169-7118

National Provider Directory

National Provider Directory

Locations

4640 Cass St
Unit 90924
San Diego, CA 92169
Phone (360) 531-7121

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1114702693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 CASS ST UNIT 90924",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921697118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 CASS ST UNIT 90924",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921697118",
            "telephone_number": "619-940-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADIGM PSYCHOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "BUNDERSON",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "PSYD",
        "authorized_official_telephone_number": "619-940-4345",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.