Individual provider Active NPI

Mark Kunze, PSY.D.

  • Clinical Psychologist
  • Coalinga, CA
National Provider Identifier
1356048847
Registry record updated Jul 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34841 Issued in CA
Practice address
24511 W Jayne Ave
Coalinga, CA 93210-9503
Phone
(559) 935-4300
NPI assigned
Feb 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2024

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 PSY34841 CA Primary

Addresses

Primary practice location

24511 W Jayne Ave
Coalinga, CA 93210-9503

Mailing address

PO Box 271
Hanford, CA 93232-0271
Phone (650) 713-1800

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

State licenses

LicenseStateTypeSpecialty
PSY34841CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1676332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720224000000",
    "number": "1356048847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932320271",
            "telephone_number": "650-713-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24511 W JAYNE AVE",
            "city": "COALINGA",
            "state": "CA",
            "postal_code": "932109503",
            "telephone_number": "559-935-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNZE",
        "first_name": "MARK",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-14",
        "last_updated": "2024-07-06",
        "certification_date": "2024-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coalinga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2024; 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.