Dustin Kieschnick, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

32828 Issued in CA

Practice address

497 Tahoe Keys Blvd Apt 35
South Lake Tahoe, CA 96150-3841

Phone

(910) 467-3217

NPI assigned

Sep 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

84.89 of 100Reported as group

Quality

81.13

Improvement activities

40

Cost

71.5

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dustin Kieschnick, PSYD

  • Clinical Psychologist
  • South Lake Tahoe, CA
  • NPI 1932033677
  NPD Authorized official
• UCSF Medical Group Business Services

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104
  NPD
• UCSF Psychiatry

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1427105279
  NPD
• University of California San Francisco

  • Surgery Physician
  • San Francisco, CA
  • NPI 1346329380
  NPD
• University of California San Francisco

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD
• University of California San Francisco

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  NPD

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1154090017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 TAHOE KEYS BLVD APT 35",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503841",
            "telephone_number": "910-467-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 TAHOE KEYS BLVD APT 35",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503841",
            "telephone_number": "910-467-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESCHNICK",
        "first_name": "DUSTIN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "32828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "address_1": "198 Tiger Tail Rd",
            "city": "Olympic Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "961469783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda Penney Keel, PH.D.
• Brian N Kelly, PT
• Christianne Bijasa Kernes, LMFT
• Jessica Keys, RD
• Kids Place 4 ABA Inc
• Jennifer Kile
• Katherine Klover
• Paul Michael Knight, MD
• Danielle Marie Knowlton, MA, FAAA
• Karlee Lyn Koeppen

• Clinical Psychologist in South Lake Tahoe, CA
• Providers in South Lake Tahoe, 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 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.