Individual provider Active NPI

Kirsten Fleming, PH.D.

  • Clinical Neuropsychologist
  • Newport Beach, CA
National Provider Identifier
1992723373
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY 15190 Issued in CA
Practice address
200 Newport Center Dr
Suite 203
Newport Beach, CA 92660-7501
Phone
(714) 206-4630
Fax
(714) 731-0304
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY 15190 CA Primary

Addresses

Primary practice location

200 Newport Center Dr
Suite 203
Newport Beach, CA 92660-7501

Mailing address

14001 Howland Way
Tustin, CA 92780-2131
Phone (714) 731-2194

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
I20061030000523 CA Practitioner - Clinical Psychologist 0749287050 Practice locations: Tustin, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14001 Howland Way
Tustin, CA 92780-2131
Phone (714) 206-4630

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 15190CAMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992723373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 HOWLAND WAY",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802131",
            "telephone_number": "714-731-2194",
            "fax_number": "714-731-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NEWPORT CENTER DR",
            "address_2": "SUITE 203",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607501",
            "telephone_number": "714-206-4630",
            "fax_number": "714-731-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING",
        "first_name": "KIRSTEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 15190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.