Individual provider Active NPI

Kevin Scott Thomas, PH.D.

  • Clinical Psychologist
  • Irvine, CA
National Provider Identifier
1285846741
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20836 Issued in CA
Practice address
4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 PSY20836 CA Primary

Addresses

Primary practice location

4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780

Mailing address

4040 Barranca Pkwy Ste 260
Irvine, CA 92604-4780
Phone (925) 282-1778

Other practice location 1

232 W Main St Ste 101
Tustin, CA 92780-7712
Phone (714) 728-2424

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
I20170117002583 CA Practitioner - Clinical Psychologist 3476835950 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

4040 Barranca Pkwy
Suite 260
Irvine, CA 92604-4780
Phone (925) 282-1778

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Aug 17, 2024 Accepting new patients
Cognitive Care Solutions Group Inc CurrentSince Jan 1, 2017 Accepting new patients
Pacific Coast Psychiatric Associates Inc PastSince Feb 9, 2020 Accepting new patients

Locations

4040 Barranca Pkwy
Ste 260
Irvine, CA 92604

3943 Irvine Blvd
Irvine, CA 92602
Phone (714) 922-0120

23461 S Pointe Dr
Ste 240
Laguna Hills, CA 92653
Phone (714) 545-3390

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1285846741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PKWY STE 260",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044780",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 BARRANCA PKWY STE 260",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044780",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 W Main St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927807712",
            "country_code": "US",
            "telephone_number": "714-728-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KEVIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.