Lauren Elizabeth Kettmann, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY22182 Issued in CA

Practice address

1400 Veterans Blvd
Department of Psychiarty
Redwood City, CA 94063-2612

Phone

(650) 299-4764

Fax

(650) 299-4335

NPI assigned

Jan 21, 2009

Sex

Female

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

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1578701041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 VETERANS BLVD",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632037",
            "telephone_number": "650-299-4764",
            "fax_number": "650-299-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 VETERANS BLVD",
            "address_2": "DEPARTMENT OF PSYCHIARTY",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940632612",
            "telephone_number": "650-299-4764",
            "fax_number": "650-299-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTMANN",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY22182",
            "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": "1150 Veterans Blvd",
            "city": "Redwood City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940632037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charlotte Kernan Moore
• Timothy Kershenstine
• Hearmon Semere Kesete
• Jaycie Kessell
• Karen Marie Ketner, NP
• Kate Lauren Kevorken, PT, DPT
• Follin Armfield Key, PH.D.
• Laura Herrera Khalifia
• Asma Khan
• James Khan, MD

• Psychologist in Redwood City, CA
• Providers in Redwood City, CA by specialty
• 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.