Individual provider Active NPI

Kathleen D Tingus, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1952416190
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16629 Issued in CA
Practice address
300 Medical Plaza
B200
Los Angeles, CA 90095-0001
Phone
(310) 794-1195
Fax
(310) 794-7491
NPI assigned
Aug 20, 2006
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X PSY16629 CA
Clinical Psychologist 103TC0700X PSY16629 CA Primary
Neurology Physician 2084N0400X PSY1662 CA

Addresses

Primary practice location

300 Medical Plaza
B200
Los Angeles, CA 90095-0001

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
PSY166290MedicaidCA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081023000786 CA Practitioner - Clinical Psychologist 4385702042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UC RegentsGroup PAC ID 0749180453, 148 clinicians

Practice addresses (Care Compare)

300 Medical PLZ
Los Angeles, CA 90095-6502
Phone (310) 825-9989

Merit-based Incentive Payment System (MIPS)

Final score
88.32 of 100Reported as group
Quality
76.01
Promoting interoperability
100
Improvement activities
40
Cost
56.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16629CAMDAdult Development & Aging Psychologist
PSY1662CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Neurology CurrentSince Jan 1, 2008 Accepting new patients
UC Regents Adult Development & Aging CurrentSince Feb 23, 2016 Accepting new patients
The Regents of the University of California CurrentSince Jan 1, 2008 Accepting new patients

Locations

300 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-8438

300 Medical Plz
Ste B200
Los Angeles, CA 90095
Phone (310) 794-6596

300 UCLA Medical Plz
Ste B200
Los Angeles, CA 90095
Phone (310) 405-9824

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

760 Westwood Plz
Rm C8749
Los Angeles, CA 90095

760 Westwood Plz
Ste C8749
Los Angeles, CA 90095
Phone (310) 206-8100

File 2939
Los Angeles, CA 90074
Phone (310) 794-6596

Organizations & group practices 3

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1952416190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL PLAZA",
            "address_2": "B200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-794-1195",
            "fax_number": "310-794-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINGUS",
        "first_name": "KATHLEEN",
        "middle_name": "D",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY16629",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16629",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "PSY1662",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY166290",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.