Individual provider Active NPI

Kristen Hashioka, PSY.D

  • Clinical Psychologist
  • La Jolla, CA
National Provider Identifier
1346496684
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28315 Issued in CA
Practice address
8813 Villa la Jolla Dr Ste 2002
La Jolla, CA 92037-1927
Phone
(760) 672-6828
Fax
(760) 683-6183
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 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 PSY28315 CA Primary

Addresses

Primary practice location

8813 Villa la Jolla Dr Ste 2002
La Jolla, CA 92037-1927

Mailing address

PO Box 1063
Carlsbad, CA 92018-1063
Phone (760) 672-6828

Other identifiers 2

IdentifierTypeStateIssuer
7420MedicaidCA
7068MedicaidCA

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
I20161229001645 CA Practitioner - Clinical Psychologist 2567743727 Practice locations: La Jolla, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3252 Holiday CT
Suite 105
La Jolla, CA 92037-1807
Phone (760) 672-6828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28315CAMDClinical Psychologist
28315CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard M. Wachsman, M.D. a Medical Corporation Past Accepting new patients

Organizations & group practices 1

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": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1346496684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1063",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920181063",
            "telephone_number": "760-672-6828",
            "fax_number": "760-683-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8813 VILLA LA JOLLA DR STE 2002",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371927",
            "telephone_number": "760-672-6828",
            "fax_number": "760-683-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASHIOKA",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7420",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7068",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.