Lorraine Killpack, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY13917 Issued in CA

Practice address

1330 Lincoln Ave Ste 309
San Rafael, CA 94901-2143

Phone

(415) 479-7551

NPI assigned

Mar 23, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497872840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE STE 309",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012143",
            "telephone_number": "415-479-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE STE 309",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012143",
            "telephone_number": "415-479-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLPACK",
        "first_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY139170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharina Kienboeck, M.A.
• Maria Kieu
• Bradley Reed Kilgore, AU.D.
• Michael Kilivris
• Kevin M. Killelea
• Steven Peter Killpack, MD
• Lumiel Kim-Hammerich, L.AC.
• Christian K Kim, MD
• Christine Kim
• Cindy Kim

• Clinical Psychologist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Clinical Psychologist in California

• 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.