Individual provider Active NPI

Paul Krebs, PHD

  • Psychologist
  • San Diego, CA
National Provider Identifier
1982907424
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY32156 Issued in CA
Practice address
3604 4TH Ave Ste 5
San Diego, CA 92103-4118
Phone
(646) 820-7477
NPI assigned
Dec 6, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 018694 NY
Psychologist 103T00000X PSY32156 CA Primary

Addresses

Primary practice location

3604 4TH Ave Ste 5
San Diego, CA 92103-4118

Mailing address

2017 Lapeyrouse St
New Orleans, LA 70116-1742
Phone (646) 820-7477

Other practice location 1

444 W 35th St Apt 12A
New York, NY 10001-1553
Phone (646) 820-7477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120409000008 NY Practitioner - Clinical Psychologist 9931360534 Practice locations: New York, NY
I20220221000567 CA Practitioner - Clinical Psychologist 9931360534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

226 W 26TH St
Suite 4
New York, NY 10001-6700
Phone (646) 820-7477

3604 4TH Ave
Suite 5
San Diego, CA 92103-4118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY32156CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Krebs Psychologist, Apc Psychologist CurrentSince Oct 5, 2021 Accepting new patients

Locations

3604 4th Ave
Ste 5
San Diego, CA 92103
Phone (619) 356-0811

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1982907424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 LAPEYROUSE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701161742",
            "telephone_number": "646-820-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 4TH AVE STE 5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034118",
            "telephone_number": "646-820-7477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "444 W 35th St Apt 12A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100011553",
            "country_code": "US",
            "telephone_number": "646-820-7477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KREBS",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-06",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018694",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY32156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.