Samantha Kilbourne

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

33751 Issued in CA

Practice address

25060 Hancock Ave Unit 103-143
Murrieta, CA 92562-5930

Phone

(951) 852-0564

NPI assigned

Apr 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1134445547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25060 HANCOCK AVE UNIT 103-143",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625930",
            "telephone_number": "951-852-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25060 HANCOCK AVE UNIT 103-143",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625930",
            "telephone_number": "951-852-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBOURNE",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134445547",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Noelle Kilian
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• Alan Hwan Kim
• Candice Jinhee Kim, MD
• Dennis Yoochun Kim, M.D.

• Clinical Psychologist in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.