Individual provider Active NPI

Kimberly Loewen Bohy, PSY.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1558520718
Registry record updated Nov 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY23978 Issued in CA
Practice address
3990 Old Town Ave
Suite A208
San Diego, CA 92110-2930
Phone
(619) 794-4229
Fax
(619) 550-1468
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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 PSY23978 CA Primary

Addresses

Primary practice location

3990 Old Town Ave
Suite A208
San Diego, CA 92110-2930

Mailing address

3990 Old Town Ave
Suite A208
San Diego, CA 92110-2930
Phone (619) 794-4229

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
I20110913000247 CA Practitioner - Clinical Psychologist 9537330105 Reassigns benefits to 1 organization
Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duet Psychological Services IncGroup PAC ID 1759712268, 2 clinicians

Practice addresses (Care Compare)

3990 Old Town Ave
Suite A208
San Diego, CA 92110-2967
Phone (619) 794-4229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duet Psychological Services, Inc. Clinical CurrentSince Mar 18, 2020 Accepting new patients

Locations

3990 Old Town Ave
Ste A208
San Diego, CA 92110
Phone (619) 786-0674

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1558520718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE",
            "address_2": "SUITE A208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102930",
            "telephone_number": "619-794-4229",
            "fax_number": "619-550-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE",
            "address_2": "SUITE A208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102930",
            "telephone_number": "619-794-4229",
            "fax_number": "619-550-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHY",
        "first_name": "KIMBERLY",
        "middle_name": "LOEWEN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY23978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.