Individual provider Active NPI

Kristen Golba, PHD

  • Clinical Psychologist
  • Temple, TX
National Provider Identifier
1407149156
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
080611 Issued in IA
Practice address
1901 Veterans Memorial Dr
Mail Code: 116B
Temple, TX 76504-7451
Phone
(254) 743-0040
NPI assigned
May 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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 080611 IA Primary

Addresses

Primary practice location

1901 Veterans Memorial Dr
Mail Code: 116B
Temple, TX 76504-7451

Mailing address

1901 Veterans Memorial Dr
Temple, TX 76504-7451
Phone (254) 743-0040

Other practice location 1

3600 30th St
Des Moines, IA 50310-5753
Phone (515) 699-5956

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
080611IAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1407149156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 VETERANS MEMORIAL DR",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047451",
            "telephone_number": "254-743-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 VETERANS MEMORIAL DR",
            "address_2": "MAIL CODE: 116B",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047451",
            "telephone_number": "254-743-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 30th St",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503105753",
            "country_code": "US",
            "telephone_number": "515-699-5956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLBA",
        "first_name": "KRISTEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-26",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "080611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.