Kristin M Whiteside, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 20134 Issued in CA

Practice address

345 Saxony Rd
Suite 102
Encinitas, CA 92024-2787

Phone

(760) 707-7540

NPI assigned

Jan 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Maya Klein Psychology, PC

  • Clinical Psychologist
  • Tigard, OR
  • NPI 1003364019
  NPD (past)

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1821236365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SAXONY RD",
            "address_2": "SUITE 102",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242787",
            "telephone_number": "760-707-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAXONY RD",
            "address_2": "SUITE 102",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242787",
            "telephone_number": "760-707-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Wheeler, DPT
• Kevin Whelan, CMT
• Daniel Ellsworth White III
• Sydney Noelle White, RN, CLC
• Neysa Dale Whiteman, MD
• Matthew Raymond Whitmore
• Whole Life Home Health Care, Inc.
• Jay Robert Wick, LMFT
• Mary Berger Wiggins, LCSW
• Will & Chan Dental Corporation

• Clinical Psychologist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.