Individual provider Active NPI

Kristen Michelle Dahlin, M.A.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1285946558
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY30126 Issued in CA
Practice address
9666 Businesspark Ave
Ste 105
San Diego, CA 92131
Phone
(619) 663-9314
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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 PSY30126 CA Primary

Addresses

Primary practice location

9666 Businesspark Ave
Ste 105
San Diego, CA 92131

Mailing address

9666 Businesspark Ave
Ste 105
San Diego, CA 92131-1646
Phone (619) 663-9314

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PSY30126CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1285946558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9666 BUSINESSPARK AVE",
            "address_2": "STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921311646",
            "telephone_number": "619-663-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9666 BUSINESSPARK AVE",
            "address_2": "STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92131",
            "telephone_number": "619-663-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLIN",
        "first_name": "KRISTEN",
        "middle_name": "MICHELLE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

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