Jaclyn Purkiss, PsyD
Psychologist, Clinical in San Diego, CA. Individual provider (NPI-1).
NPI number1245985183
StatusActive
Last updated in NPPESJan 15, 2025
Details
- NPI
- 1245985183
- Entity type
- Individual (NPI-1)
- Name
- Jaclyn Purkiss
- Credential
- PsyD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 18, 2022
- Certification date
- Jan 15, 2025
- Last updated
- Jan 15, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 35581 | CA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
3525 Del Mar Heights Rd # 1952San Diego, CA 92130-2199
Phone 562-242-4386
Mailing address
3525 Del Mar Heights Rd # 1952San Diego, CA 92130-2199
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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