Individual provider Active NPI

Kristen Maria O'Shea, PHD

  • Clinical Psychologist
  • Nevada City, CA
National Provider Identifier
1447372909
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24237 Issued in CA
Practice address
825 Zion St
Nevada City, CA 95959-2922
Phone
(530) 264-0494
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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 24237 CA Primary

Addresses

Primary practice location

825 Zion St
Nevada City, CA 95959-2922

Mailing address

PO Box 34
Auburn, CA 95604-0034
Phone (530) 401-8112

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130628000254 CA Practitioner - Clinical Psychologist 9537309380 Reassigns benefits to 1 organization
Practice locations: Nevada City, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

825 Zion St
Nevada City, CA 95959-2922
Phone (530) 264-0494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
24237CAMDOccupational Therapist

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1447372909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956040034",
            "telephone_number": "530-401-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 ZION ST",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592922",
            "telephone_number": "530-264-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "KRISTEN",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nevada City, CA

Sources for this page

Verify at the official NPI Registry.