Paul K Chitwood, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY14963 Issued in CA

Practice address

4811 Chippendale Dr
# 302
Sacramento, CA 95841-2555

Phone

(916) 349-9403

NPI assigned

Jul 23, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1932584539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 CHIPPENDALE DR",
            "address_2": "# 302",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412555",
            "telephone_number": "916-349-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 CHIPPENDALE DR",
            "address_2": "# 302",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412555",
            "telephone_number": "916-349-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITWOOD",
        "first_name": "PAUL",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-23",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY14963",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14963",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY14963",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "PSY14963",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2829 Watt Ave",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elitas Mazhyanga Chirwa, APCC
• Evan Chisum, MD
• Zahabiya Huzefa Chithiwala, M.H.S, M.D
• Shubhangi Chitnis, M.D.
• Kerrie Lemons Chitwood, M.A. CCC-SLP
• David Chiu
• Kevin Ngu Chiu, MD
• Louise Lowe Chiu, M.D.
• Peter Chiu, MD
• Richard Chiu, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.