Kintsugi TMS

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

KINTSUGI TMS

Practice address

24012 Calle de la Plata Ste 430
Laguna Hills, CA 92653-7623

Phone

(949) 500-8833

NPI assigned

May 6, 2020

Organization subpart

No

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

Authorized official

Name

Josh Sweeney

Title

Manager

Phone

(949) 500-8833

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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

• Tatyana Ellison, M.D.

  • Psychiatry Physician
  • Laguna Hills, CA
  • NPI 1477868578
  NPD

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1275154783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24012 CALLE DE LA PLATA STE 430",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537623",
            "telephone_number": "949-500-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24012 CALLE DE LA PLATA STE 430",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537623",
            "telephone_number": "949-500-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINTSUGI TMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "SWEENEY",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "949-500-8833"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477868578",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "LUMINELLO.COM",
            "affiliation": "N",
            "address_1": "24012 Calle De La Plata Ste 430",
            "city": "Laguna Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926537623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stanley C Kimball III, DDS
• King Premium Care
• Renee D King, PHARMD
• Alexa Ray Kinley, HS
• Kintsugi Health
• Lisa Kipper, PHARMD
• Keean Andrew Kirk, MA, AMFT
• Kristy Kirkland
• Karin Klapova, LMFT
• Elvira Klause, M.D

• Psychiatry Physician in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.