Kimberly Fara Corbett, PSYD, MFT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY21669 Issued in CA

Practice address

4411 30TH St Ste 101
San Diego, CA 92116-4286

Phone

(619) 298-2098

Fax

(619) 298-2098

NPI assigned

Sep 23, 2006

Last updated

Sep 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kimberly Corbett, Psy.D., a Psychological Corp.

  dba Kimberly Corbett, Psy.D., M.F.T.

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1245458132
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1235239823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 MOUNT ASHMUN DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921113952",
            "telephone_number": "619-298-2098",
            "fax_number": "619-298-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 30TH ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921164286",
            "telephone_number": "619-298-2098",
            "fax_number": "619-298-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "KIMBERLY",
        "middle_name": "FARA",
        "name_prefix": "Dr.",
        "credential": "PSYD, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PIN",
            "identifier": "776634000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PIN",
            "identifier": "0PL216690",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7314642",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY216690",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA PIN",
            "identifier": "0PL216690",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN PROVIDER ID NUMBER",
            "identifier": "352923",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Edward Corbett
• Bryan Michael Corbett
• Donna Christine Corbett, PSY.D.
• Forest Corbett
• Julia Corbett
• Stephanie Lynn Corbett, CRNA
• Takisha M Corbett, PHD
• Shalaine Brooke Corbilla, DNP, FNP-BC
• Corbin Smith DMD Dental Corp.
• Ann Corbin-Fulchiron, LCSW, CADC-II

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.