Individual provider Active NPI

Karen Hawthorne, PHD

  • Psychologist
  • Santa Ysabel, CA
National Provider Identifier
1750449625
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
MF16894 Issued in CA
Practice address
30240 Hwy 78
Santa Ysabel, CA 92070
Phone
(760) 765-3578
Fax
(760) 765-2810
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

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
Psychologist 103T00000X MF16894 CA Primary

Addresses

Primary practice location

30240 Hwy 78
Santa Ysabel, CA 92070

Mailing address

PO Box 35
Santa Ysabel, CA 92070
Phone (760) 765-3578

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
I20240126002584 CA Practitioner - Marriage and Family Therapist 5193880706 Practice locations: Santa Ysabel, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30240 Hwy 78
Santa Ysabel, CA 92070-9733
Phone (760) 440-6900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MF16894CAMDPsychologist
16894CAMDSpeech-Language Pathologist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750449625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35",
            "city": "SANTA YSABEL",
            "state": "CA",
            "postal_code": "92070",
            "telephone_number": "760-765-3578",
            "fax_number": "760-765-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30240 HWY 78",
            "city": "SANTA YSABEL",
            "state": "CA",
            "postal_code": "92070",
            "telephone_number": "760-765-3578",
            "fax_number": "760-765-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "MF16894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ysabel, CA

Sources for this page

Verify at the official NPI Registry.