Organization Active NPI

Katherine M Kilgore PHD Inc

  • Clinical Psychologist
  • Folsom, CA
National Provider Identifier
1770765794
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 14094 Issued in CA
Legal business name
KATHERINE M KILGORE PHD INC
Practice address
13405 Folsom Blvd
Suite 220
Folsom, CA 95630-4738
Phone
(916) 357-5999
NPI assigned
Nov 30, 2007
Last updated
Nov 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Authorized official

Name
Katherine Kilgore, PHDNPI 1932210481
Title
Owner
Phone
(916) 458-5505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY 14094 CA Primary

Addresses

Primary practice location

13405 Folsom Blvd
Suite 220
Folsom, CA 95630-4738

Mailing address

13405 Folsom Blvd
Suite 220
Folsom, CA 95630-4738
Phone (916) 357-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406000909 CA Part B Supplier - Clinic/Group Practice 7911990957 Receives reassigned benefits from 1 practitioner
Practice locations: Folsom, CA

National Provider Directory

National Provider Directory

Locations

13405 Folsom Blvd
Ste 220
Folsom, CA 95630
Phone (916) 272-1690

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1770765794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13405 FOLSOM BLVD",
            "address_2": "SUITE 220",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956304738",
            "telephone_number": "916-357-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13405 FOLSOM BLVD",
            "address_2": "SUITE 220",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956304738",
            "telephone_number": "916-357-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE M KILGORE PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-458-5505",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 14094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.