Individual provider Active NPI

Uri Kugel, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1164893442
Registry record updated Aug 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28642 Issued in CA
Practice address
5230 Carroll Canyon Rd
Ste 100
San Diego, CA 92121-1779
Phone
(510) 213-8740
NPI assigned
Oct 13, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2019

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 PSY28642 CA Primary

Addresses

Primary practice location

5230 Carroll Canyon Rd
Ste 100
San Diego, CA 92121-1779

Mailing address

7462 Brentwood St
San Diego, CA 92111-4330
Phone (510) 213-8740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opted out of Medicare
Yes, effective Oct 1, 2026 through Oct 1, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129001736 CA Practitioner - Clinical Psychologist 0446530976 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY28642CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kendra Penski Licensed Clinical Social Worker Inc PastSince Jul 1, 2020 Accepting new patients
Whole Person-Psychotherapy Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1164893442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7462 BRENTWOOD ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921114330",
            "telephone_number": "510-213-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 CARROLL CANYON RD",
            "address_2": "STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211779",
            "telephone_number": "510-213-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUGEL",
        "first_name": "URI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-13",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.