Individual provider Active NPI

Jeffrey Kitts Bone, PSY.D.

  • Clinical Psychologist
  • Newport Beach, CA
National Provider Identifier
1194947986
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 20017 Issued in CA
Practice address
4060 Campus Dr
Suite 130
Newport Beach, CA 92660-2217
Phone
(949) 375-4028
Fax
(949) 861-6174
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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 PSY 20017 CA Primary

Addresses

Primary practice location

4060 Campus Dr
Suite 130
Newport Beach, CA 92660-2217

Mailing address

4060 Campus Dr
Suite 130
Newport Beach, CA 92660-2217
Phone (949) 375-4028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050801000626 CA Practitioner - Clinical Psychologist 1759319767 Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 Corporate Plaza Dr
Suite 150
Newport Beach, CA 92660-7908
Phone (949) 375-4028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 20017CAMDClinical Psychologist
20017CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1194947986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR",
            "address_2": "SUITE 130",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602217",
            "telephone_number": "949-375-4028",
            "fax_number": "949-861-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR",
            "address_2": "SUITE 130",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602217",
            "telephone_number": "949-375-4028",
            "fax_number": "949-861-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONE",
        "first_name": "JEFFREY",
        "middle_name": "KITTS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.