Individual provider Active NPI

Kyrstle Barrera Salvador, PH.D.

  • Clinical Neuropsychologist
  • Loma Linda, CA
National Provider Identifier
1689988362
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY 26933 Issued in CA
Practice address
11406 Loma Linda Dr
Loma Linda, CA 92354-3711
Phone
(909) 558-6523
NPI assigned
Aug 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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 PSY 26933 CA Primary

Addresses

Primary practice location

11406 Loma Linda Dr
Loma Linda, CA 92354-3711

Mailing address

11406 Loma Linda Dr
Loma Linda, CA 92354-3711
Phone (909) 558-6523

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
I20150727003005 CA Practitioner - Clinical Psychologist 6204140858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11406 Loma Linda Dr
Suite 300
Loma Linda, CA 92354-3711
Phone (909) 558-6277

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 26933CAMDClinical Neuropsychologist
26933CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 16, 2015 Accepting new patients
Faculty Physicians and Surgeons of Llusm Clinical Neuropsychologist CurrentSince Aug 16, 2015 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients

Locations

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1689988362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11406 LOMA LINDA DR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543711",
            "telephone_number": "909-558-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11406 LOMA LINDA DR",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543711",
            "telephone_number": "909-558-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALVADOR",
        "first_name": "KYRSTLE",
        "middle_name": "BARRERA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 26933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.