Kristine Pickwith

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY33158 Issued in CA

Practice address

23121 Verdugo Dr Ste 204
Laguna Hills, CA 92653-1339

Phone

(424) 237-3989

NPI assigned

Oct 3, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 20, 2023 through Dec 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Heart Strings Psychological Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ventura, CA
  • NPI 1912749789
  NPD Authorized official

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662768000000",
    "number": "1730638628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8780 19TH ST # 410",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917014608",
            "telephone_number": "424-237-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23121 VERDUGO DR STE 204",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531339",
            "telephone_number": "424-237-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICKWITH",
        "first_name": "KRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2022-09-10",
        "certification_date": "2022-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis S Phillips, MD
• Laura Phillips, LCSW
• Phoenix Rising Addcition Center Inc.
• Truong Phung
• Susan Ephraim Pick, LCSW
• Pierce-Reynolds Chiropractic Corp
• Avalon A Pierce
• Jennifer Pierce, M.A.
• Seth R Pincus
• Pinnacle Pain & Regenerative Medicine Inc

• Clinical Psychologist in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.