Individual provider Active NPI

Katherine Grace Yoder

  • Child & Adolescent Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1619619756
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
20A24109 Issued in CA
Practice address
3020 Childrens Way # 5018
San Diego, CA 92123-4223
Phone
(858) 966-7759
NPI assigned
Apr 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 20A24109 CA Primary
Child & Adolescent Psychiatry Physician 2084P0804X 24109 CA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3020 Childrens Way # 5018
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # 5018
San Diego, CA 92123-4223
Phone (858) 966-7759

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250715001161 CA Practitioner - Psychiatry 6608256557 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A24109CAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Jul 1, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Jul 1, 2025 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 3

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": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1619619756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # 5018",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # 5018",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "KATHERINE",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-09",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "20A24109",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "24109",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.