Kathlyn Clementelli

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY28217 Issued in CA

Legal business name

KATHLYN CLEMENTELLI

Practice address

3212 Tenley Dr
San Jose, CA 95148-3639

Phone

(408) 204-8518

NPI assigned

Jan 23, 2017

Organization subpart

No

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

Authorized official

Name

Kathlyn Clementelli, PH.D.

Title

Psychologist

Phone

(408) 204-8518

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1659818060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 TENLEY DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951483639",
            "telephone_number": "408-204-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 TENLEY DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951483639",
            "telephone_number": "408-204-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLYN CLEMENTELLI",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "CLEMENTELLI",
        "authorized_official_first_name": "KATHLYN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "408-204-8518",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY28217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "97726",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhona Kastle, LMFT
• Mallory Katavich
• Kate Viernes, Licensed Clinical Social Worker, PC
• Himasri Kathi, PSY
• Kathleen Kesten, MFT
• Kathryn a. Havis-Faler
• Kathy My Nguyen Chiropractic
• Kathy Nguyen Chiropractic Corp.
• Bogdan Katkov
• Jan Phung Kato, MD

• Psychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.