Individual provider Active NPI

Karlotta L Bartholomew, PH.D.

  • Clinical Psychologist
  • San Ramon, CA
National Provider Identifier
1497855258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 10548 Issued in CA
Practice address
2817 Crow Canyon Rd
Suite 204
San Ramon, CA 94583-1639
Phone
(925) 831-0341
Fax
(925) 855-9075
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY 10548 CA Primary

Addresses

Primary practice location

2817 Crow Canyon Rd
Suite 204
San Ramon, CA 94583-1639

Mailing address

2817 Crow Canyon Rd
Suite 204
San Ramon, CA 94583-1639
Phone (925) 831-0341

Other identifiers 2

IdentifierTypeStateIssuer
94 3073338OtherCAFEDERAL TAX ID
PSY 10548OtherCAPSYCHOLOGY LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 10548CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497855258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 CROW CANYON RD",
            "address_2": "SUITE 204",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831639",
            "telephone_number": "925-831-0341",
            "fax_number": "925-855-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 CROW CANYON RD",
            "address_2": "SUITE 204",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831639",
            "telephone_number": "925-831-0341",
            "fax_number": "925-855-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "KARLOTTA",
        "middle_name": "L",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 10548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "94 3073338",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE NUMBER",
            "identifier": "PSY 10548",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.