Kimberly June Light-Allende, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 20476 Issued in CA

Practice address

15218 Summit Ave # 300-313
Fontana, CA 92336-0232

Phone

(909) 425-7487

Fax

(909) 463-7410

NPI assigned

Mar 22, 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

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gregor Medical CorporationGroup PAC ID 2668832700, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Gregor Medical Corporation

  • Multi-Specialty Clinic/Center
  • Rancho Cucamonga, CA
  • NPI 1275274003
  Medicare reassignment Care Compare group NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Patton, CA
  • NPI 1043249204
  NPD
• Department of State Hospitals

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497872915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15218 SUMMIT AVENUE #300-313",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360232",
            "telephone_number": "909-425-7487",
            "fax_number": "909-463-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15218 SUMMIT AVE # 300-313",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923360232",
            "telephone_number": "909-425-7487",
            "fax_number": "909-463-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHT-ALLENDE",
        "first_name": "KIMBERLY",
        "middle_name": "JUNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nasser T Liasi, MD
• Aurora Libbey
• Amy Chin Lien, PHARMD
• Mei Lieu
• Light of Life Hospice Care, LLC
• Lijale Home Health LLC
• Lila Pharmacy Inc.
• Catalina C. Lim, MD
• Nancy Go Lim, MD
• Nelly Lim, PA-C

• Clinical Psychologist in Fontana, CA
• Providers in Fontana, 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.
• 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.