Kimberly Paige Holloway, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY30604 Issued in CA

Practice address

1550 Hotel Cir N Ste 450
San Diego, CA 92108-2933

Phone

(619) 692-1581

Fax

(619) 692-1588

NPI assigned

Nov 4, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.holloway.p1@direct.pcsd.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585
  Medicare reassignment NPD
• Mark David Levine, MD Burlingame PC

  • Psychiatry Physician
  • San Mateo, CA
  • NPI 1770709263
  NPD (past)

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1811326515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 HOTEL CIR N STE 450",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082933",
            "telephone_number": "619-692-1581",
            "fax_number": "619-692-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLOWAY",
        "first_name": "KIMBERLY",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY30604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCSD MEDICARE #",
            "identifier": "W416",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennie Lynn Hollis, MSW INTERN
• Myra Hollis
• Stacy Lenay Hollomon, LMFT
• Lovelyn Hollon
• Breanna Marie Holloway, MA
• Petrona D Holloway
• Holly Hinderberger Dental Corporation
• Holly Valerio, M.D., Inc.
• Edward Kelly Holly, D.D.S.
• Amy Lynn Holm, RDN

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.