Active NPI
Kenna Marva Mauhili, PSY.D.
- Clinical Psychologist
- Oceanside, CA
National Provider Identifier
1386949360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY23713
- Practice address
- 619 Crouch St
Oceanside, CA 92054-4460 - Phone
- (760) 736-6767
- NPI assigned
- Jan 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY23713 | CA | Primary |
Addresses
Primary practice location
619 Crouch St
Oceanside, CA 92054-4460
Mailing address
PO Box 642
Carlsbad, CA 92018-0642
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY23713 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North County Health Project Inc | Clinical | Current | Accepting new patients |
| Prowellness Academy | Past | Accepting new patients | |
| Community Research Foundation Inc | Past | Accepting new patients |
Locations
619 Crouch St
Oceanside, CA 92054
619 Crouch St
Ste 100
Oceanside, CA 92054
Phone (760) 736-6700
1675 N Perris Blvd
Ste G1
Perris, CA 92571
Phone (730) 736-6700
150 Valpreda Rd
San Marcos, CA 92069
Phone (619) 736-6700
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1952328700
-
- Federally Qualified Health Center (FQHC)
- Oceanside, CA
- NPI 1245770825
Clinical
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1598988180
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Westlake Village, CA
- NPI 1093348484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676332800000",
"number": "1386949360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 642",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920180642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 CROUCH ST",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920544460",
"telephone_number": "760-736-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUHILI",
"first_name": "KENNA",
"middle_name": "MARVA",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-21",
"last_updated": "2023-02-14",
"certification_date": "2023-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY23713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oceanside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.