Organization Active NPI

Duet Psychological Services, Inc.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1790304947
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DUET PSYCHOLOGICAL SERVICES, INC.
Practice address
3990 Old Town Ave Ste A208
San Diego, CA 92110-2967
Phone
(619) 794-4229
Fax
(619) 330-2003
NPI assigned
Apr 8, 2020
Last updated
Apr 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Kimberly Loewen, PSY.D.
Title
Clinical Psychologist
Phone
(619) 794-4229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

3990 Old Town Ave Ste A208
San Diego, CA 92110-2967

Mailing address

3990 Old Town Ave Ste A208
San Diego, CA 92110-2967
Phone (619) 794-4229

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200518002273 CA Part B Supplier - Clinic/Group Practice 1759712268 Receives reassigned benefits from 2 practitioners
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1586304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1790304947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE STE A208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102967",
            "telephone_number": "619-794-4229",
            "fax_number": "619-330-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 OLD TOWN AVE STE A208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921102967",
            "telephone_number": "619-794-4229",
            "fax_number": "619-330-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUET PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "LOEWEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "619-794-4229",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.