Individual provider Active NPI

Gina Louise Keys, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1700938453
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY18563 Issued in CA
Practice address
3699 Park Blvd
San Diego, CA 92103-4546
Phone
(619) 300-8195
NPI assigned
Jan 16, 2007
Sex
Female
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 Psychologist 103TC0700X PSY18563 CA Primary

Addresses

Primary practice location

3699 Park Blvd
San Diego, CA 92103-4546

Mailing address

3699 Park Blvd
San Diego, CA 92103-4546
Phone (619) 300-8195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700938453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3699 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034546",
            "telephone_number": "619-300-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3699 PARK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034546",
            "telephone_number": "619-300-8195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYS",
        "first_name": "GINA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.