Individual provider Active NPI

John Michael Kuiper, PHD

  • Clinical Psychologist
  • Redding, CA
National Provider Identifier
1518029412
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14346 Issued in CA
Practice address
1936 Shasta St
A
Redding, CA 96001-0407
Phone
(530) 339-0920
NPI assigned
Dec 15, 2006
Last updated
Aug 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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 PSY14346 CA Primary

Addresses

Primary practice location

1936 Shasta St
A
Redding, CA 96001-0407

Mailing address

19090 Hollow Lane
Redding, CA 96003-9532
Phone (530) 339-0920

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120111000457 CA Practitioner - Clinical Psychologist 5092982215 Practice locations: Redding, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1936 Shasta St a
Redding, CA 96001-0407
Phone (530) 339-0920

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1518029412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19090 HOLLOW LANE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960039532",
            "telephone_number": "530-339-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 SHASTA ST",
            "address_2": "A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010407",
            "telephone_number": "530-339-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUIPER",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.