NPIMap

Organization Active NPI

Shift: a Psychological Corporation

  • Psychologist
  • Newport Beach, CA
National Provider Identifier
1134744147
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SHIFT: A PSYCHOLOGICAL CORPORATION
Practice address
4063 Birch St Ste 220
Newport Beach, CA 92660-2241
Phone
(480) 329-0544
NPI assigned
Jun 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Dr. David Kyle Bond, PHDNPI 1134740509
Title
Owner
Phone
(949) 329-3779

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

4063 Birch St Ste 220
Newport Beach, CA 92660-2241

Mailing address

3334 E Coast Hwy # 509
Corona del Mar, CA 92625-2328
Phone (480) 329-0544

Other identifiers 1

IdentifierTypeStateIssuer
PSY31794OtherCAPSYCHOLOGY LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kyle@shift-psychology.com Direct

National Provider Directory

National Provider Directory

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": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1134744147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 E COAST HWY # 509",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252328",
            "telephone_number": "480-329-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4063 BIRCH ST STE 220",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602241",
            "telephone_number": "480-329-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFT: A PSYCHOLOGICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-329-3779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE",
            "identifier": "PSY31794",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle@shift-psychology.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email or Text",
            "address_1": "4063 Birch St Ste 220",
            "city": "Newport Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926602241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.