Individual provider Active NPI

Kathleen Stanton, PH.D

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1346697885
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
30654 Issued in CA
Practice address
1001 Potrero Ave RM 7M8
San Francisco, CA 94110-3518
Phone
(415) 206-4444
NPI assigned
May 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X 30654 CA Primary

Addresses

Primary practice location

1001 Potrero Ave RM 7M8
San Francisco, CA 94110-3518

Mailing address

1001 Potrero Ave RM 7M8
San Francisco, CA 94110-3518

Other practice location 1

3301 E 12th St Ste 259
Oakland, CA 94601-2940
Phone (510) 269-9030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230119001663 TX Practitioner - Clinical Psychologist 3375914831 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38859TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Clinical CurrentSince Dec 12, 2022 Accepting new patients
Tri-County Clinical Current Accepting new patients
St Health TX, P.a. Past Accepting new patients
Luis Alesandro Larrazabal Martinez MD PC Psychologist Past Accepting new patients

Locations

4900 Mueller Blvd
#2S
Austin, TX 78723
Phone (512) 324-3315

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

Interoperability endpoints

  • Direct secure messaging: kathleen.stanton.1@8363.direct.athenahealth.com

Organizations & group practices 4

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": "1463184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1346697885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE RM 7M8",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE RM 7M8",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 E 12th St Ste 259",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946012940",
            "country_code": "US",
            "telephone_number": "510-269-9030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANTON",
        "first_name": "KATHLEEN",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-14",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "30654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.