Kristin Marie Katz, PH.D.
Individual provider Active NPI Psychologist · Talbott, TN
NPI 1386837532 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1386837532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- P3001 (TN)
- Practice address
- 6350 W a J Hwy
Talbott, TN 37877 - Phone
- (423) 587-7337
- Fax
- (423) 586-0614
- NPI assigned
- Aug 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160301000995 | CA | Practitioner - Clinical Psychologist | 5496916983 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26898 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Current |
Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
1320 Standiford Ave
Ste 5
Modesto, CA 95350
Phone (209) 323-0229
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
1 Quality Dr
Vacaville, CA 95688
Phone (707) 453-5000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | P3001 | TN | Yes |
Addresses
Primary practice location
6350 W a J Hwy
Talbott, TN 37877
Mailing address
6350 W a J Hwy
Department 100
Talbott, TN 37877
Phone (800) 355-3565
Other names
- Kristin Marie Plachetka
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Talbott, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.