Carrie Kristen Evenden Dvornik, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY24740 Issued in CA

Practice address

3354 Sacramento St Ste E
San Francisco, CA 94118

Phone

(415) 793-9643

NPI assigned

Jan 23, 2012

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

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carrie K. Evenden, Psy.D. Psychotherapy Corporation

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1376217307
  Medicare reassignment NPD
• Pacific Coast Psychiatric Associates Inc

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465
  NPD (past)

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1285905232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 SACRAMENTO ST",
            "address_2": "STE E",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181948",
            "telephone_number": "415-793-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 SACRAMENTO ST STE E",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94118",
            "telephone_number": "415-793-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORNIK",
        "first_name": "CARRIE",
        "middle_name": "KRISTEN EVENDEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James E Duzak, NP
• Dva Healthcare Renal Care Inc
• Dva Healthcare Renal Care Inc
• Khary Rashad Dvorak-Ewell I
• Mary Genevieve Dvorak, PSY.D.
• Joseph Raymond Dwaihy, M.D.
• Urvi Dwivedi
• Carissa Dwiwardani
• Jordanna Eve Dworkin, L.AC.
• Samantha Shelby Dwoskin, PNP-AC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.