Kristin Nicole Herzberg Purdy, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

27449 Issued in CA

Practice address

5480 Baltimore Dr
#250
La Mesa, CA 91942-2020

Phone

(310) 863-0767

NPI assigned

Nov 3, 2015

Last updated

Nov 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kristin Nicole Herzberg Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1467825125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR",
            "address_2": "#250",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422020",
            "telephone_number": "310-863-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR",
            "address_2": "#250",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422020",
            "telephone_number": "310-863-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZBERG PURDY",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "27449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "HERZBERG",
            "middle_name": "NICOLE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wendy Corina Herrera, DDS
• Jerry Thomas Herring, DDS
• Richard Scott Herrod, DDS
• Danica Melissa Hertzig
• Paul David Hervey, P.T.
• Denise Marie Hespeler, LMFT
• Richard Clarke Heyes, LMFT
• Maria D. Hicks
• Rena Hiedo
• William Loughman Higgins, PH.D.

• Psychologist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.