Individual provider Active NPI

Kristopher Ian Stevens, PH.D.

  • Clinical Psychologist
  • Monrovia, CA
National Provider Identifier
1649409459
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
29045 Issued in CA
Practice address
902 S Myrtle Ave
First Floor
Monrovia, CA 91016-3427
Phone
(626) 303-1541
NPI assigned
Jul 14, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 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 29045 CA Primary

Addresses

Primary practice location

902 S Myrtle Ave
First Floor
Monrovia, CA 91016-3427

Mailing address

902 S Myrtle Ave
First Floor
Monrovia, CA 91016-3427
Phone (626) 303-1541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1649409459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S MYRTLE AVE",
            "address_2": "FIRST FLOOR",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163427",
            "telephone_number": "626-303-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S MYRTLE AVE",
            "address_2": "FIRST FLOOR",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "910163427",
            "telephone_number": "626-303-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KRISTOPHER",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-14",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.