Fred Kutnick

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW92260 Issued in CA

Practice address

3665 Kearny Villa Rd Ste 165
San Diego, CA 92123-1954

Phone

(858) 966-8471

NPI assigned

Dec 30, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1669011276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "949-833-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 KEARNY VILLA RD STE 165",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231954",
            "telephone_number": "858-966-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTNICK",
        "first_name": "FRED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-30",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW92260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suraj Raghuraj Kushvah
• Nicholas Kusnezov, M.D.
• Courtney Zimmerman Kutach, NP
• Kutner Therapy, an Individual & Family Counseling Corporation
• Kate Kutner, LMFT
• Angela D. Kutsunis, DO
• Michelle Olaes Eguico Kutters
• Michael Bernd Kutzscher, MD
• Tyler Kuwamoto, DMD
• Kuwan Corp

• Mental Health Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.