Lauren Jean Kissner, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A109864 Issued in CA

Practice address

1131 Community Parkway
Hollister, CA 95023

Phone

(831) 636-4020

Fax

(831) 636-4025

NPI assigned

Apr 11, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Bernardino, CA
  • NPI 1164467023
  Medicare reassignment NPD
• County of San Benito Behavioral Health

  • Case Management Agency
  • Hollister, CA
  • NPI 1790525871
  NPD
• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rialto, CA
  • NPI 1245534023
  NPD
• County of San Bernardino

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apple Valley, CA
  • NPI 1346950904
  NPD
• San Benito County

  • Clinic/Center
  • Hollister, CA
  • NPI 1255461471
  NPD

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1972776763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 COMMUNITY PARKWAY",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-636-4020",
            "fax_number": "831-636-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 COMMUNITY PARKWAY",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-636-4020",
            "fax_number": "831-636-4025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 Customer Care Way",
            "address_purpose": "LOCATION",
            "city": "Atwater",
            "state": "CA",
            "postal_code": "953015167",
            "country_code": "US",
            "telephone_number": "209-384-6493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "268 W Hospitality Ln",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924150026",
            "country_code": "US",
            "telephone_number": "909-382-3087",
            "fax_number": "909-382-3106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSNER",
        "first_name": "LAUREN",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-11",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A109864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A109864",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joseph Lee Klapper, M.D.
• Klarix Group LLC
• Kenneth W Kovanda, DDS
• Lori A Kraus, PA
• Ray S. Kusumoto, PA

• Psychiatry Physician in Hollister, CA
• Providers in Hollister, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.