Individual provider Active NPI

Cory E Kowalski, PHD

  • Clinical Psychologist
  • Riverside, CA
National Provider Identifier
1770201709
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
33356 Issued in CA
Practice address
4280 Latham St Ste G
Riverside, CA 92501-1737
Phone
(909) 295-5805
NPI assigned
Aug 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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 33356 CA Primary

Addresses

Primary practice location

4280 Latham St Ste G
Riverside, CA 92501-1737

Mailing address

11201 Benton St
Loma Linda, CA 92357-1000
Phone (909) 894-7455

Other names 1

  • Cory E Harrison Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL cory.kowalski@va.gov Direct

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
I20241112002854 CA Practitioner - Clinical Psychologist 6305370495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Psychological Services IncGroup PAC ID 1658744974, 13 clinicians

Practice addresses (Care Compare)

3633 Inland Empire Blvd
Suite 777
Ontario, CA 91764-7974
Phone (909) 295-5805

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33356CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Psychological Services Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

3633 Inland Empire Blvd
Ste 777
Ontario, CA 91764
Phone (909) 235-5662

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1770201709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "909-894-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 LATHAM ST STE G",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011737",
            "telephone_number": "909-295-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWALSKI",
        "first_name": "CORY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "cory.kowalski@va.gov",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11201 Benton St",
            "city": "Loma Linda",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923571000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CORY",
            "last_name": "HARRISON",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.