Cassandra Mary Kauffman, PSYD
Individual provider Active NPI Clinical Psychologist · Lakeside, CA
NPI 1780845396 · NPPES record last updated May 26, 2026
Key facts
- NPI
- 1780845396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY 25899 (CA)
- Practice address
- 11962 Woodside Ave
Lakeside, CA 92040-2914 - Phone
- (619) 722-0014
- Fax
- (619) 327-4174
- NPI assigned
- Jun 17, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Psychology Services PC
Practice addresses (Care Compare)
11962 Woodside Ave
Lakeside, CA 92040-2914
Phone (619) 591-1222
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190925003551 | CA | Practitioner - Clinical Psychologist | 5698005163 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 25899 | CA | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 25899 | CA | Yes |
Addresses
Primary practice location
11962 Woodside Ave
Lakeside, CA 92040-2914
Mailing address
PO Box 18228
Irvine, CA 92623-8228
Phone (619) 722-0014
Other practice location 1
2120 Alpine Blvd
Alpine, CA 91901-2113
Phone (619) 659-3122
Other practice location 2
4033 6th Ave
San Diego, CA 92103-2202
Phone (619) 722-0014
Other practice location 3
8351 Broadway
Lemon Grove, CA 91945-2009
Phone (619) 722-0014
Other providers in Lakeside, CA
- Catherine Elaine Horger
- Hos Care Inc
- James a. Cloyd DDS Inc.
- Omar Johnson
- Robert Johnson
- Vania Knight
- Christian Michael Kondan
- John E. Kramer
- Sarah Kyanza Kyanza
- Lakeside Fire Protection
All providers in Lakeside, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.