Active NPI
Kimberly June Legh-Page, PHD
- Clinical Psychologist
- Modesto, CA
National Provider Identifier
1972984110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY35504
- Practice address
- 1620 Cummins Dr
Modesto, CA 95358-6400 - Phone
- (832) 265-1424
- NPI assigned
- Jun 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Marriage & Family Therapist | 106H00000X | 87753 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | PSY35504 | CA | Primary |
Addresses
Primary practice location
1620 Cummins Dr
Modesto, CA 95358-6400
Mailing address
2760 Rancheria Dr
Shingle Springs, CA 95682-9522
Phone (832) 265-1424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY35504 | CA | MD | Clinical Psychologist |
| 87753 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1972984110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2760 RANCHERIA DR",
"city": "SHINGLE SPRINGS",
"state": "CA",
"postal_code": "956829522",
"telephone_number": "832-265-1424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 CUMMINS DR",
"city": "MODESTO",
"state": "CA",
"postal_code": "953586400",
"telephone_number": "832-265-1424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGH-PAGE",
"first_name": "KIMBERLY",
"middle_name": "JUNE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-12",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "87753",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY35504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.