Kristin Jane Van de Carr

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY11296 Issued in CA

Practice address

2 Crow Canyon CT
Suite 200
San Ramon, CA 94583-1953

Phone

(925) 838-4036

Fax

(925) 838-4039

NPI assigned

Dec 31, 2006

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

Other names 1

• Dr. Kristin Jane Van de Carr Professional name

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861558967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CROW CANYON CT",
            "address_2": "SUITE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831953",
            "telephone_number": "925-838-4036",
            "fax_number": "925-838-4039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROW CANYON CT",
            "address_2": "SUITE 200",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831953",
            "telephone_number": "925-838-4036",
            "fax_number": "925-838-4039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DE CARR",
        "first_name": "KRISTIN",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY11296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "VAN DE CARR",
            "middle_name": "JANE",
            "prefix": "DR.",
            "credential": "PHD.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brianna L Valentine
• Emmanuel M Valino, DDS
• Karina Valle
• Valley Digestive Care
• Kyle Bruce Van Brocklin, D.M.D., M.S.
• Harry Robert Van Den Berg, DDS
• Alison Van Hoff, 1-15-18398
• Sabrina Van Zuiden
• Samuel H Vance
• Anitha Vancha

• Clinical Psychologist in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.