Kristin Read Campos, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29401 Issued in CA

Practice address

5955 Capistrano Ave Ste E
Atascadero, CA 93422-7227

Phone

(805) 703-5330

NPI assigned

Jul 1, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2022 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Resilience Psychological Collaborative, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Atascadero, CA
  • NPI 1518435171

  Cognitive & Behavioral

  NPD Authorized official

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635033600000",
    "number": "1154737948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 CAPISTRANO AVE STE E",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934227227",
            "telephone_number": "805-703-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 CAPISTRANO AVE STE E",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934227227",
            "telephone_number": "805-703-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "KRISTIN",
        "middle_name": "READ",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-01",
        "last_updated": "2021-10-24",
        "certification_date": "2021-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "29401",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "29401",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• California Clia Consultant LLC
• Brianna Calvert, LCSW
• Deja Shante Camacho
• Lilina R. Camello, LMFT
• Kenneth Lawrence Campos, M.D.
• Dana Steven Cancaro, D.C.
• Shannon Joann Cantillano, LCSW
• Jennifer Cardenas
• Courtney Carman
• Caitlin Kay Carnes

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.