Individual provider Active NPI

Charles Frank Kairys, PSY.D.

  • Clinical Psychologist
  • Westlake Village, CA
National Provider Identifier
1396935698
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY24995 Issued in CA
Practice address
3625 E Thousand Oaks Blvd
Ste 209
Westlake Village, CA 91362-3566
Phone
(818) 645-3337
Fax
(805) 496-1973
NPI assigned
Aug 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 PSY24995 CA Primary

Addresses

Primary practice location

3625 E Thousand Oaks Blvd
Ste 209
Westlake Village, CA 91362-3566

Mailing address

3625 E Thousand Oaks Blvd
Ste 209
Westlake Village, CA 91362-3566
Phone (818) 645-3337

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
24995CAMDMental Health Counselor
PSY24995CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways to Peace Psychotherapy Center Incorporated CurrentSince Mar 1, 2020 Accepting new patients

Locations

3625 E Thousand Oaks Blvd
Ste 209
Westlake Village, CA 91362
Phone (818) 231-7291

Organizations & group practices 1

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1396935698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 E THOUSAND OAKS BLVD",
            "address_2": "STE 209",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623566",
            "telephone_number": "818-645-3337",
            "fax_number": "805-496-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 E THOUSAND OAKS BLVD",
            "address_2": "STE 209",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913623566",
            "telephone_number": "818-645-3337",
            "fax_number": "805-496-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIRYS",
        "first_name": "CHARLES",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.