Individual provider Active NPI

Michael Howard Kabat, PHD

  • Clinical Neuropsychologist
  • La Jolla, CA
National Provider Identifier
1669401360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
21344 Issued in CA
Practice address
9834 Genesee Ave
Suite 427
La Jolla, CA 92037-1223
Phone
(858) 652-9668
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 21344 CA Primary

Addresses

Primary practice location

9834 Genesee Ave
Suite 427
La Jolla, CA 92037-1223

Mailing address

2356 Cambridge Ave
Cardiff, CA 92007-2002
Phone (410) 258-1140

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
I20071022000305 CA Practitioner - Clinical Psychologist 5294821203 Practice locations: La Jolla, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9834 Genesee Ave
Suite 221
La Jolla, CA 92037-1215
Phone (858) 652-9668

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21344CAMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669401360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 CAMBRIDGE AVE",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920072002",
            "telephone_number": "410-258-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE",
            "address_2": "SUITE 427",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371223",
            "telephone_number": "858-652-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABAT",
        "first_name": "MICHAEL",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "21344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.