Ori Kochavi, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY16411 Issued in CA

Practice address

801 Traeger Ave Ste 209
Kaiser - Dept. of Child & Adolescent Psychiatry
San Bruno, CA 94066-3048

Phone

(650) 742-2737

Fax

(650) 742-7135

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1578620464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EL CAMINO REAL",
            "address_2": "KAISER - DEPT. OF CHILD & ADOLESCENT PSYCHIATRY",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803208",
            "telephone_number": "650-742-2737",
            "fax_number": "650-742-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TRAEGER AVE STE 209",
            "address_2": "KAISER - DEPT. OF CHILD & ADOLESCENT PSYCHIATRY",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940663048",
            "telephone_number": "650-742-2737",
            "fax_number": "650-742-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHAVI",
        "first_name": "ORI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kathryn Win Kiskinen
• Jill Noel Klingensmith
• Karina Ko
• Megan Elizabeth Ko
• Lyndee Kobayashi
• Alana Kochieva
• Keith Kofutua
• Frances Kong, LMFT
• Kaylin Kong
• Nancy Kong, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.