Active NPI
Kelly Vanzutphen
- Clinical Neuropsychologist
- Windsor, CA
National Provider Identifier
1235368572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY21716
- Practice address
- 9940 Starr Rd.
Ste 140
Windsor, CA 95492 - Phone
- (707) 569-4545
- Fax
- (707) 431-2334
- NPI assigned
- Jul 8, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY21716 | CA | Primary |
Addresses
Primary practice location
9940 Starr Rd.
Ste 140
Windsor, CA 95492
Mailing address
PO Box 1497
Healdsburg, CA 95448
Phone (707) 569-4545
Other names 1
- Kelly Hunter
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY21716 | CA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247011200000",
"number": "1235368572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1497",
"city": "HEALDSBURG",
"state": "CA",
"postal_code": "95448",
"telephone_number": "707-569-4545",
"fax_number": "707-431-2334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9940 STARR RD.",
"address_2": "STE 140",
"city": "WINDSOR",
"state": "CA",
"postal_code": "95492",
"telephone_number": "707-569-4545",
"fax_number": "707-431-2334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANZUTPHEN",
"first_name": "KELLY",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-08",
"last_updated": "2009-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY21716",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "HUNTER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Windsor, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.