Individual provider Active NPI

Katrine Enrile, M.D.

  • Psychiatry Physician
  • Pasadena, CA
National Provider Identifier
1952514051
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A108230 Issued in CA
Practice address
92 N Madison Ave # 2
Pasadena, CA 91101-1740
Phone
(626) 542-7236
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X A108230 CA Primary

Addresses

Primary practice location

92 N Madison Ave # 2
Pasadena, CA 91101-1740

Mailing address

92 N Madison Ave # 2
Pasadena, CA 91101-1740

Other practice location 1

1950 3rd St
La Verne Counseling and Psychological Services
LA Verne, CA 91750-4401
Phone (909) 448-4105

Other practice location 2

9353 Valley Blvd
Rosemead, CA 91770-1923
Phone (626) 287-2988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 28, 2022 through Jun 28, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
108230CAMDDentist
A108230CAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1952514051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 N MADISON AVE # 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 N MADISON AVE # 2",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011740",
            "telephone_number": "626-542-7236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 3rd St",
            "address_2": "La Verne Counseling and Psychological Services",
            "address_purpose": "LOCATION",
            "city": "LA Verne",
            "state": "CA",
            "postal_code": "917504401",
            "country_code": "US",
            "telephone_number": "909-448-4105",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9353 Valley Blvd",
            "address_purpose": "LOCATION",
            "city": "Rosemead",
            "state": "CA",
            "postal_code": "917701923",
            "country_code": "US",
            "telephone_number": "626-287-2988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENRILE",
        "first_name": "KATRINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A108230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.