Kerry Dean Kravitz, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G048260 Issued in CA

Practice address

4370 Alpine Rd
Suite 210
Portola Valley, CA 94028-7952

Phone

(650) 529-2333

Fax

(650) 529-2337

NPI assigned

Sep 11, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 31, 2013 through Dec 31, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225132269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 CONTINENTAL DR",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940256622",
            "telephone_number": "650-854-7076",
            "fax_number": "650-233-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 ALPINE RD",
            "address_2": "SUITE 210",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287952",
            "telephone_number": "650-529-2333",
            "fax_number": "650-529-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVITZ",
        "first_name": "KERRY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G048260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nile Kiyoto Jones, RN
• Courtney Blaire Jonson, L.AC.
• Daniel Aaron Kaplan, RN
• Jessica Kassis, M.D.
• Ann Therese Kearney, MA
• Krista Regedanz, PHD, a Psychological Organization
• Richard Horton Laude, M.D.
• Jamie Leach, D.D.S.
• Fariba Lessani, O.D.
• Jia Rebecca Li, LMFT

• Psychiatry Physician in Portola Valley, CA
• Providers in Portola Valley, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.