Kristin M Makena, LICENSED EDUC. PSYCH

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

3575 Issued in CA

Practice address

1461 Higuera St Ste D
San Luis Obispo, CA 93401-2948

Phone

(619) 977-7224

NPI assigned

Mar 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1750148839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 E GRAND AVE # 103-327",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934202421",
            "telephone_number": "619-977-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 HIGUERA ST STE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012948",
            "telephone_number": "619-977-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKENA",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "LICENSED EDUC. PSYCH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "3575",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "CA",
            "license": "3575",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CA",
            "license": "3575",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "CA",
            "license": "3575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Maier, AMFT
• Craig G Main, D.D.S.
• Talia Main
• Tea Main, AMFT
• Barbara Y Mair, PSYD
• Diana Marie Makowetski
• Zoe Ray Makowetski
• Eva Malama, CMT
• Henry Abdel Malek, M.D.
• Mary L Malik, PHD

• Cognitive & Behavioral Psychologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Cognitive & Behavioral Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.