Katya Cornejo, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

23822 Issued in CA

Practice address

1833 Fillmore St
Suite 102
San Francisco, CA 94115-3180

Phone

(415) 572-1126

Fax

(415) 931-3166

NPI assigned

Jan 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1144374729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 29TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941213515",
            "telephone_number": "415-948-6992",
            "fax_number": "415-235-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1833 FILLMORE ST",
            "address_2": "SUITE 102",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153180",
            "telephone_number": "415-572-1126",
            "fax_number": "415-931-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEJO",
        "first_name": "KATYA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "23822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie Corlito
• Erin Rose Cormican
• Nicholas Stephen Cormier, M.D.
• William Robert Corn, MD
• Juan Ramon Cornejo Sr.
• Samantha Rayleen Cornejo
• Sheilah Cornelio
• Iris Rene Cornelious
• Alicia Alexandria Cornelius
• Ella Gibson Cornell, MD

• Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.