Active NPI
Victoria Korge, PSY.D.
- Clinical Psychologist
- Kamuela, HI
National Provider Identifier
1356788905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1195
- Practice address
- 65-1206 Mamalahoa Hwy
# 1-205
Kamuela, HI 96743-7303 - Phone
- (808) 885-7444
- Fax
- (808) 885-0716
- NPI assigned
- May 22, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1195 | HI | Primary |
| Clinical Psychologist | 103TC0700X | 31115 | TX |
Addresses
Primary practice location
65-1206 Mamalahoa Hwy
# 1-205
Kamuela, HI 96743-7303
Mailing address
65-1206 Mamalahoa Hwy
# 1-205
Kamuela, HI 96743-7303
Phone (808) 885-7444
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1195 | HI | MD | Clinical Psychologist |
| 31115 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1356788905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65-1206 MAMALAHOA HWY",
"address_2": "# 1-205",
"city": "KAMUELA",
"state": "HI",
"postal_code": "967437303",
"telephone_number": "808-885-7444",
"fax_number": "808-885-0716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65-1206 MAMALAHOA HWY",
"address_2": "# 1-205",
"city": "KAMUELA",
"state": "HI",
"postal_code": "967437303",
"telephone_number": "808-885-7444",
"fax_number": "808-885-0716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORGE",
"first_name": "VICTORIA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-22",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "HI",
"license": "1195",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "31115",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kamuela, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.