Individual provider Active NPI

Haran Kingstan, PSYD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1376995100
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP6176 Issued in MN
Practice address
3734 6TH Ave
San Diego, CA 92103-4317
Phone
(619) 354-7400
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X MN
Clinical Psychologist 103TC0700X LP6176 MN Primary

Addresses

Primary practice location

3734 6TH Ave
San Diego, CA 92103-4317

Mailing address

3734 6TH Ave
San Diego, CA 92103-4317
Phone (619) 354-7400

Other practice location 1

1437 Van Buren Ave
Saint Paul, MN 55104-1929
Phone (612) 269-0250 ext. 90250

Other practice location 2

8451 E Point Douglas Rd S
Cottage Grove, MN 55016-3331
Phone (651) 255-8573

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
LP6176MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alchemy and Insight Inc. Clinical Current Accepting new patients
Hillcrest Psychological Associates, PC CurrentSince Jul 3, 2022 Accepting new patients
Hillcrest Psychological Associates, PC CurrentSince Jul 3, 2022 Accepting new patients

Locations

3734 6th Ave
San Diego, CA 92103
Phone (619) 354-7400

Organizations & group practices 3

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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376995100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 6TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034317",
            "telephone_number": "619-354-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 6TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034317",
            "telephone_number": "619-354-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1437 Van Buren Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551041929",
            "country_code": "US",
            "telephone_number": "612-269-0250 x90250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8451 E Point Douglas Rd S",
            "address_purpose": "LOCATION",
            "city": "Cottage Grove",
            "state": "MN",
            "postal_code": "550163331",
            "country_code": "US",
            "telephone_number": "651-255-8573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINGSTAN",
        "first_name": "HARAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2022-07-21",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.