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

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY21669 Issued in CA

Legal business name

KIMBERLY CORBETT, PSY.D., A PSYCHOLOGICAL CORP.

Practice address

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

Phone

(619) 298-2098

Fax

(619) 298-2098

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Fara Corbett, PSY.D., M.F.T.NPI 1235239823

Title

President/Ceo

Phone

(619) 298-0169

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Kimberly Corbett, Psy.D., M.F.T. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Fara Corbett, PSYD, MFT

  • Clinical Psychologist
  • San Diego, CA
  • NPI 1235239823
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189814400000",
    "number": "1245458132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6757 FRIARS RD UNIT 21",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085013",
            "telephone_number": "619-298-0169",
            "fax_number": "619-298-0169"
        },
        {
            "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": {
        "organization_name": "KIMBERLY CORBETT, PSY.D., A PSYCHOLOGICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-09-15",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "FARA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "619-298-0169",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., M.F.T."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21669",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC39583",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "352923",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7314642",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD AND TRICARE",
            "identifier": "MFC395830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimberly Corbett, Psy.D., M.F.T.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Patton Kimball, M.D.
• Sarah Elise Kimball
• Sunwook Kimbang, LCSW
• Sara Beth Kimber
• Maxwell Lambert Kimberley-Bryant, PA-C
• Kimberly Hoover L.Ac.
• Kimberly Israel, a Licensed Clinical Social Worker Professional Corporation
• Kimberly M. Sandberg, RN, Crna, a Professional Corporation
• Kimberly Whiteford
• Elizabeth Kimble

• 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 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.