Active NPI
Kimberly Nicole Vasquez
- Cognitive & Behavioral Psychologist
- Los Angeles, CA
National Provider Identifier
1740947068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- Practice address
- 1049 E 21St St
Los Angeles, CA 90011-1115 - Phone
- (323) 443-5183
- NPI assigned
- Nov 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | Primary |
Addresses
Primary practice location
1049 E 21St St
Los Angeles, CA 90011-1115
Mailing address
1049 E 21St St
Los Angeles, CA 90011-1115
Phone (323) 443-5183
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y9227721 | Other | CA | MEDICAL |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637539200000",
"number": "1740947068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1049 E 21ST ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900111115",
"telephone_number": "323-443-5183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1049 E 21ST ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900111115",
"telephone_number": "323-443-5183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASQUEZ",
"first_name": "KIMBERLY",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-22",
"last_updated": "2021-11-22",
"certification_date": "2021-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "Y9227721",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.