Individual provider Active NPI

Julie Danielle Kunin, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1225136278
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16703 Issued in CA
Practice address
211 W Robinson Ave
San Diego, CA 92103-4019
Phone
(619) 912-0468
Fax
(619) 294-2153
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 PSY16703 CA Primary

Addresses

Primary practice location

211 W Robinson Ave
San Diego, CA 92103-4019

Mailing address

211 W Robinson Ave
San Diego, CA 92103-4019
Phone (619) 912-0468

Other identifiers 2

IdentifierTypeStateIssuer
231640OtherCAHEALTH NET/MHN
2614233MedicaidCA

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
I20101021001117 CA Practitioner - Clinical Psychologist 6901099035 Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3368 2ND Ave
Suite G
San Diego, CA 92103-5666
Phone (619) 787-4406

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY16703CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1225136278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W ROBINSON AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034019",
            "telephone_number": "619-912-0468",
            "fax_number": "619-294-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W ROBINSON AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034019",
            "telephone_number": "619-912-0468",
            "fax_number": "619-294-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNIN",
        "first_name": "JULIE",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET/MHN",
            "identifier": "231640",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2614233",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.