Individual provider Active NPI

Kira Quinn

  • Psychologist
  • Mill Valley, CA
National Provider Identifier
1629395504
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
33980 Issued in CA
Practice address
45 Camino Alto Ste 201B
Mill Valley, CA 94941-2935
Phone
(415) 871-1389
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 33980 CA Primary

Addresses

Primary practice location

45 Camino Alto Ste 201B
Mill Valley, CA 94941-2935

Mailing address

610 Steiner St Apt 3
San Francisco, CA 94117-2530
Phone (415) 871-1389

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
I20230404001522 CA Practitioner - Clinical Psychologist 0941675011 Reassigns benefits to 1 organization
Practice locations: Mill Valley, CA

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
An Elegant Sufficiency, a Psychological Corporation CurrentSince Feb 1, 2023 Accepting new patients
Community Institute for Psychotherapy Past Accepting new patients
Community Institute for Psychotherapy Past Accepting new patients

Locations

2431 W March Ln
Ste 200
Stockton, CA 95207
Phone (209) 200-8305

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1629395504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 STEINER ST APT 3",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941172530",
            "telephone_number": "415-871-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CAMINO ALTO STE 201B",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412935",
            "telephone_number": "415-871-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "KIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "33980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.