Individual provider Active NPI

Katerina Paige Prossr, PHD

  • Psychologist
  • Oceanside, CA
National Provider Identifier
1871011239
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY30544 Issued in CA
Practice address
3355 Mission Ave Ste 111
Oceanside, CA 92058-1327
Phone
(760) 492-5656
Fax
(760) 826-4900
NPI assigned
Sep 6, 2017
Last updated
Nov 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X PSY30544 CA Primary
Clinical Psychologist 103TC0700X PSY30544 CA

Addresses

Primary practice location

3355 Mission Ave Ste 111
Oceanside, CA 92058-1327

Mailing address

3355 Mission Ave Ste 111
Oceanside, CA 92058-1327
Phone (760) 492-5656

Other identifiers 1

IdentifierTypeStateIssuer
1467978817MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drfeebywooden@truenorthpsychservices.com True North Psychological Services, Inc.

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY30544CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Psychological Services, Inc. Clinical PastSince Nov 6, 2022 Accepting new patients
Aliuddin Khaja, MD., Inc PastSince Jul 1, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1871011239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 MISSION AVE STE 111",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920581327",
            "telephone_number": "760-492-5656",
            "fax_number": "760-826-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 MISSION AVE STE 111",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920581327",
            "telephone_number": "760-492-5656",
            "fax_number": "760-826-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSSR",
        "first_name": "KATERINA",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY30544",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30544",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467978817",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drfeebywooden@truenorthpsychservices.com",
            "affiliation": "Y",
            "affiliationName": "True North Psychological Services, Inc.",
            "address_1": "3355 Mission Ave Ste 111",
            "city": "Oceanside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920581327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.