Active NPI
Jessica A Kaczorowski, PH.D.
- Psychologist
- Calabasas, CA
National Provider Identifier
1467689422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 26784
- Practice address
- 4768 Park Granada
Suite 101
Calabasas, CA 91302 - Phone
- (805) 267-9466
- NPI assigned
- Jun 17, 2009
- Last updated
- Feb 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 26784 | CA | Primary |
Addresses
Primary practice location
4768 Park Granada
Suite 101
Calabasas, CA 91302
Mailing address
1260 Ella St
Unit 3
San Luis Obispo, CA 93401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 24, 2026 through Feb 24, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455580800000",
"number": "1467689422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 ELLA ST",
"address_2": "UNIT 3",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "93401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4768 PARK GRANADA",
"address_2": "SUITE 101",
"city": "CALABASAS",
"state": "CA",
"postal_code": "91302",
"telephone_number": "805-267-9466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACZOROWSKI",
"first_name": "JESSICA",
"middle_name": "A",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-17",
"last_updated": "2016-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "26784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calabasas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.