Active NPI
Katya Lenore Waitzkin, PYSD
- Clinical Psychologist
- San Francisco, CA
National Provider Identifier
1790035210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 33213
- Practice address
- 126 Church St
San Francisco, CA 94114-1111 - Phone
- (415) 289-9973
- NPI assigned
- Sep 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 33213 | CA | Primary |
Addresses
Primary practice location
126 Church St
San Francisco, CA 94114-1111
Mailing address
46 Camp St
San Francisco, CA 94110-1119
Phone (415) 289-9973
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33213 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647475200000",
"number": "1790035210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 CAMP ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941101119",
"telephone_number": "415-289-9973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 CHURCH ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941141111",
"telephone_number": "415-289-9973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITZKIN",
"first_name": "KATYA",
"middle_name": "LENORE",
"name_prefix": "Dr.",
"credential": "PYSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-12",
"last_updated": "2022-03-17",
"certification_date": "2022-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "33213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.