Kathlyn A Khoukaz, PSYD

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

License

33541 Issued in CA

Practice address

711 Center Dr # 105-7047
San Marcos, CA 92069-3500

Phone

(760) 402-9103

NPI assigned

Jun 12, 2015

Last updated

May 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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, 2019

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

Locations

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

• Kate Khoukaz Psychology Corporation

  • Clinical Psychologist
  • Carlsbad, CA
  • NPI 1437080918
  NPD Authorized official
• Pacific Center for Human Growth

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Berkeley, CA
  • NPI 1043434095
  NPD (past)
• Pacific Center for Human Growth

  • Community/Behavioral Health Agency
  • Berkeley, CA
  • NPI 1275687717
  NPD (past)
• San Diego Neuropsychology PC

  • Clinical Neuropsychologist
  • Encinitas, CA
  • NPI 1083205322
  NPD (past)

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1336520550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 CENTER DR # 105-7047",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920693500",
            "telephone_number": "760-462-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CENTER DR # 105-7047",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920693500",
            "telephone_number": "760-402-9103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10011 SE Division St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97266",
            "country_code": "US",
            "telephone_number": "503-928-3998",
            "fax_number": "541-868-2003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOUKAZ",
        "first_name": "KATHLYN",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3264",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "CA",
            "license": "33541",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Brooke Kern
• Suzanne Kestell, R.N.
• Sarah Lane Ketcham, PA-C
• Naveera Khan
• Khanda a Miller , a Professional Corp
• Bennett Kienast
• Chihee Kim
• Elijah Sangku-Daniel Kim, PMHNP-BC
• Lucy Kim
• Denton Larmarr Kimball, O.D.

• Rehabilitation Psychologist in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Rehabilitation Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.