Phillip James Atkinson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY21927 Issued in CA

Practice address

790 Mason St Ste 102
Vacaville, CA 95688-4661

Phone

(707) 874-8463

NPI assigned

Apr 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Kairos Psychology PC

  • Clinical Psychologist
  • Vacaville, CA
  • NPI 1629410022
  NPD Authorized official

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1487828620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "D-2004 MARION STREET",
            "address_2": "DIRECTORATE OF PSYCHOLOGICAL APPLICATIONS",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283105200",
            "telephone_number": "910-432-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 MASON ST STE 102",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884661",
            "telephone_number": "707-874-8463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "D-2004 Marion Street",
            "address_2": "Directorate of Psychological Applications",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283105200",
            "country_code": "US",
            "telephone_number": "910-432-6833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "PHILLIP",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-18",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arvin T. Mehta, DDS, Inc.
• Adolfo Jose Ascencio, RPH
• Crystall Ascencio, RBT
• Aeen Mostafa Asghar, MD
• Liana Mae Lugtu Atizado, OTD, OTR/L
• Wesley Atkinson
• Tonka Brushier Attoh
• Navneet Aujla, D.D.S
• Kyaw Aung, MD
• Tania Aung, M.D.

• Clinical Psychologist in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.