Keri Ann Prins Abdullah, PH.D.
Individual provider Active NPI Clinical Psychologist · San Diego, CA
NPI 1699840587 · NPPES record last updated Aug 24, 2023
Key facts
- NPI
- 1699840587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 29990 (CA)
- Practice address
- 10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364 - Phone
- (858) 695-2211
- NPI assigned
- Nov 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Health Centers of San Diego Inc
Practice addresses (Care Compare)
3514 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424
3544 30TH St
San Diego, CA 92104-4120
Phone (619) 515-2424
3705 Mission Blvd
San Diego, CA 92109-7104
Phone (619) 515-2444
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180503002147 | CA | Practitioner - Clinical Psychologist | 8426312182 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29990 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Health Centers of San Diego, Inc | Current |
Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current |
Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Community Research Foundation Inc | Past |
Accepting new patients |
Locations
2136 El Cajon Blvd
San Diego, CA 92104
Phone (619) 515-2588
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
3544 30th St
San Diego, CA 92104
Phone (619) 515-2424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 29990 | CA | Yes |
Addresses
Primary practice location
10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364
Mailing address
10717 Camino Ruiz Ste 207
San Diego, CA 92126-2364
Phone (858) 695-2211
Other practice location 1
2136 El Cajon Blvd
San Diego, CA 92104-1102
Phone (619) 906-5319
Other names
- Keri A Abdullah
Other providers in San Diego, CA
- Zeki Abdulaali
- Muna Abdulahi
- Youmna M Abdulhadi
- Amal Abdulkadir
- Abdul-Shaheed Khalil-Ullah Abdullah
- Khalid Abdullah
- Marcya Abdullah
- Nour Abdullah
- Sagal Abdiaziz Abdullahi
- Samira Abdullahi
All providers in San Diego, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.