Kirsten Marie Mason, PSYD
Individual provider Active NPI Clinical Psychologist · Represa, CA
NPI 1649575341 · NPPES record last updated Apr 20, 2023
Key facts
- NPI
- 1649575341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY30991 (CA)
- Practice address
- 100 Folsom Prison Rd
Represa, CA 95671-3172 - Phone
- (916) 985-8610
- NPI assigned
- Jan 11, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY30991 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Current |
Accepting new patients |
Locations
100 Prison Rd
Represa, CA 95671
Phone (916) 294-3061
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | PSY30991 | CA | Yes |
Addresses
Primary practice location
100 Folsom Prison Rd
Represa, CA 95671-3172
Mailing address
6884 Schindler Rd
Newcastle, CA 95658-9437
Phone (925) 768-7662
Other providers in Represa, CA
- Paul Edward Landman
- Ly Minh Le
- Benjamin Lee
- John Maciel Jr.
- Kathryn Manness
- Margaret A McAloon
- Matthew Erik McGiffen
- Timothea Greer McGinley
- Robert Charles McMahon
- Gary J McManus
All providers in Represa, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.