El Camino Psychology Services. PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY10467 Issued in CA

Legal business name

EL CAMINO PSYCHOLOGY SERVICES. PC

Practice address

2181 S El Camino Real Ste 307
Oceanside, CA 92054-6288

Phone

(760) 722-4233

Fax

(760) 722-4232

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brock Kenneth Kilbourne, PH.D.NPI 1467586701

Title

Director

Phone

(760) 722-4233

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brock Kenneth Kilbourne, PH.D.

  • Clinical Psychologist
  • Oceanside, CA
  • NPI 1467586701
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1932233178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 S EL CAMINO REAL STE 307",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546288",
            "telephone_number": "760-722-4233",
            "fax_number": "760-722-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 S EL CAMINO REAL STE 307",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546288",
            "telephone_number": "760-722-4233",
            "fax_number": "760-722-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CAMINO PSYCHOLOGY SERVICES. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "KILBOURNE",
        "authorized_official_first_name": "BROCK",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "760-722-4233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY10467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY10467",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody M Ehret
• Jason Ehrhart, PA-C
• Hailey Auriana Eidse, M.S., CF-SLP
• Eir Aura Health Nursing Corporation
• Melinda Young Eisenhower
• Karim Hossny El-Sherief, MD
• William Scott Eldon, DPT
• Courtnee Rose Olita Elento
• Elliott Frederick Elledge, M.D.
• Mariah Eller

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.