Natalie Elvita Kurniadi, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY32552 Issued in CA

Practice address

3990 Old Town Ave Ste C303
San Diego, CA 92110-2932

Phone

(858) 964-0722

Fax

(866) 437-0375

NPI assigned

Jul 19, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacific Neurobehavioral Clinic IncGroup PAC ID 9234454422, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Pacific Neurobehavioral Clinic: a Psychological Corporation

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952724817

  Clinical Neuropsychologist

  Medicare reassignment Care Compare group NPD
• Joanne M. Hamilton Psychologist a Professional Corporation

  • Clinical Neuropsychologist
  • San Diego, CA
  • NPI 1144428467
  Medicare reassignment NPD
• Community Research Foundation Inc

  dba Areta Crowell Center

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1689792533
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700
  NPD (past)

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1477808137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE STE C303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102932",
            "telephone_number": "858-964-0722",
            "fax_number": "866-437-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE STE C303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102932",
            "telephone_number": "858-964-0722",
            "fax_number": "866-437-0375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29122 Ranch Viejo Dr.",
            "address_2": "Suite 102-G",
            "address_purpose": "LOCATION",
            "city": "San Juan Capistrano",
            "state": "CA",
            "postal_code": "92675",
            "country_code": "US",
            "telephone_number": "858-693-3113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURNIADI",
        "first_name": "NATALIE",
        "middle_name": "ELVITA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY32552",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "32552",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Kuriakose, MD
• Nicole A Kuriki, PHARMD
• Michael Kurisu, D.O
• Wayne Owen Kurisu, M.D.
• Dana Elizabeth Kurland, M.S. CCC-SLP
• Rachel Kurniadi, M.D.
• Soumya Lakshmi Kurnool, MD
• Momo Kurosaka, MD
• Brian Andrew Kurpiewski
• Howard A. Kurshenbaum, MD

• Clinical Neuropsychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.