Individual provider Active NPI

Kimberly Nicole Legaspi, PSYD

  • Psychologist
  • Denver, CO
National Provider Identifier
1699250530
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY.0005987 Issued in CO
Practice address
3401 Eudora St
Denver, CO 80207-2500
Phone
(303) 825-1711
NPI assigned
Sep 26, 2018
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY.0005987 CO Primary
Clinical Child & Adolescent Psychologist 103TC2200X PSY.0005897 CO
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3401 Eudora St
Denver, CO 80207-2500

Mailing address

3401 Eudora St
Denver, CO 80207-2500

Other practice location 1

21081 S Western Ave Ste 295
Torrance, CA 90501-1707
Phone (310) 533-6600

Other practice location 2

1000 W Carson St # 498
Torrance, CA 90502-2004
Phone (424) 306-5737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20221018001087 CO Practitioner - Clinical Psychologist 7113393000 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0005987COMDPsychologist
39074TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Center of Denver CurrentSince Sep 26, 2022 Accepting new patients
Mental Health Center of Denver Current Accepting new patients
Mental Health Center of Denver CurrentSince Sep 26, 2022 Accepting new patients
Los Angeles County Department of Mental Health PastSince Sep 1, 2019 Accepting new patients

Locations

3401 Eudora St
Denver, CO 80207
Phone (303) 300-6266

4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6509

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1699250530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 EUDORA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 EUDORA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802072500",
            "telephone_number": "303-825-1711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21081 S Western Ave Ste 295",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905011707",
            "country_code": "US",
            "telephone_number": "310-533-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W Carson St # 498",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "424-306-5737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGASPI",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "PSY.0005987",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "PSY.0005897",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.