Individual provider Active NPI

Jennifer Anne Kadin, PSY.D.

  • Psychologist
  • Ventura, CA
National Provider Identifier
1700076809
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY26595 Issued in CA
Practice address
200 S Wells Rd
Suite 100
Ventura, CA 93004-1377
Phone
(805) 647-6322
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Psychological Services Inc 16 clinicians

Practice addresses (Care Compare)

30495 Canwood St
Suite 101
Agoura Hills, CA 91301-4331
Phone (818) 707-7366

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
I20160922002683 CA Practitioner - Clinical Psychologist 8921395682 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26595CAMDPsychologist
26595CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince Sep 27, 2016 Accepting new patients
Clinicas del Camino Real Inc CurrentSince Sep 27, 2016 Accepting new patients
Clinicas del Camino Real Inc Current Accepting new patients
Family Psychological Services Inc Psychologist CurrentSince Jan 1, 2020 Accepting new patients
Clinicas del Camino Real Inc Past Accepting new patients
Clinicas del Camino Real Inc Past Accepting new patients

Locations

30495 Canwood St
Ste 101
Agoura Hills, CA 91301
Phone (818) 707-7366

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

200 S Wells Rd
Ste 100
Ventura, CA 93004
Phone (805) 647-6322

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY26595 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

200 S Wells Rd
Suite 100
Ventura, CA 93004-1377

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

Other names 1

NPPES NPI Registry
  • Jennifer Anne Kadin-Hoekstra Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 2, 2016.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1700076809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S WELLS RD",
            "address_2": "SUITE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930041377",
            "telephone_number": "805-647-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADIN",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY26595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KADIN-HOEKSTRA",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.