Individual provider Active NPI

Kayla Konish, PHD

  • Clinical Psychologist
  • Corcoran, CA
National Provider Identifier
1164023396
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
32183 Issued in CA
Practice address
4001 King Ave
Corcoran, CA 93212-9611
Phone
(805) 760-0746
NPI assigned
Nov 4, 2020
Last updated
Nov 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 32183 CA Primary

Addresses

Primary practice location

4001 King Ave
Corcoran, CA 93212-9611

Mailing address

677 Montana de Oro St
Tulare, CA 93274-7403

Other names 1

  • Kayla Kinworthy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
32183CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1164023396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 MONTANA DE ORO ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932747403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 KING AVE",
            "city": "CORCORAN",
            "state": "CA",
            "postal_code": "932129611",
            "telephone_number": "805-760-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONISH",
        "first_name": "KAYLA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "32183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "KINWORTHY",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corcoran, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.