Individual provider Active NPI

Kristee Beres, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1841247871
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14899 Issued in CA
Practice address
1550 Hotel Circle North
Ste 270
San Diego, CA 92108-2908
Phone
(619) 692-1581
Fax
(619) 528-4625
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY14899 CA Primary

Addresses

Primary practice location

1550 Hotel Circle North
Ste 270
San Diego, CA 92108-2908

Mailing address

PO Box 609001
San Diego, CA 92160-9001
Phone (619) 528-4600

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY14899CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1841247871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609001",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921609001",
            "telephone_number": "619-528-4600",
            "fax_number": "619-528-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 HOTEL CIRCLE NORTH",
            "address_2": "STE 270",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921082908",
            "telephone_number": "619-692-1581",
            "fax_number": "619-528-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERES",
        "first_name": "KRISTEE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14899",
            "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 Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.