Individual provider Active NPI

Katherine Elizabeth Beckwith, PHD

  • Psychologist
  • Redwood City, CA
National Provider Identifier
1346823788
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
32528 Issued in CA
Practice address
488 Winslow St Apt 502
Redwood City, CA 94063-1878
Phone
(941) 284-9648
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 32528 CA
Clinical Psychologist 103TC0700X 32528 CA
Psychologist 103T00000X 32528 CA Primary

Addresses

Primary practice location

488 Winslow St Apt 502
Redwood City, CA 94063-1878

Mailing address

488 Winslow St Apt 502
Redwood City, CA 94063-1878
Phone (941) 284-9648

Other names 1

  • Dr. Katherine Elizabeth Dorociak Former name

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
I20211119002020 CA Practitioner - Clinical Psychologist 5698164259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kandm Neuropsychology, a Psychology CorporationGroup PAC ID 8921373184, 11 clinicians

Practice addresses (Care Compare)

100 Shoreline Hwy
Suite B386
Mill Valley, CA 94941-6609
Phone (415) 877-4408

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32528CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
K&M Neuropsychology, a Psychology Corporation CurrentSince Nov 1, 2021 Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients

Locations

100 Shoreline Hwy
Ste B386
Mill Valley, CA 94941
Phone (415) 877-4408

100 Shoreline Hwy
Ste B100
Mill Valley, CA 94941
Phone (415) 877-4408

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1346823788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488 WINSLOW ST APT 502",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631878",
            "telephone_number": "941-284-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 WINSLOW ST APT 502",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631878",
            "telephone_number": "941-284-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKWITH",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "32528",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "32528",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "32528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "DOROCIAK",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.