Active NPI
Russel Kayser, PSY.D.
- Psychologist
- Half Moon Bay, CA
National Provider Identifier
1902133853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 23066
- Practice address
- 625 Miramontes St
Half Moon Bay, CA 94019-1942 - Phone
- (650) 276-3100
- NPI assigned
- Nov 13, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 23066 | CA | Primary |
Addresses
Primary practice location
625 Miramontes St
Half Moon Bay, CA 94019-1942
Mailing address
330 Mirada Rd
Half Moon Bay, CA 94019-1312
Phone (650) 276-3100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 11, 2025 through May 11, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258070400000",
"number": "1902133853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 MIRADA RD",
"city": "HALF MOON BAY",
"state": "CA",
"postal_code": "940191312",
"telephone_number": "650-276-3100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 MIRAMONTES ST",
"city": "HALF MOON BAY",
"state": "CA",
"postal_code": "940191942",
"telephone_number": "650-276-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAYSER",
"first_name": "RUSSEL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-11-13",
"last_updated": "2009-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "23066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Half Moon Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.