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DR. MALLORY CAITLIN KIDWELL PHD
NPI 1457965865
Psychologist - Clinical in Sacramento, CA

Active since September 02, 2020PECOS Enrolled
2230 STOCKTON BLVD, SACRAMENTO, CA 95817(916) 734-3574 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 30, 2024, Sep 16, 2024, Apr 11, 2023 and 2 more (5 updates tracked since 2020).

About Dr. Mallory Caitlin Kidwell Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MALLORY CAITLIN KIDWELL PHD (NPI 1457965865) is an individual clinical provider in Sacramento, California, licensed in California (PSY35369) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457965865
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MALLORY CAITLIN KIDWELLCredential: PHD
Location Address2230 STOCKTON BLVDSacramento, CA 95817-1353
Mailing Address2230 Stockton BlvdSacramento, CA 95817-1353 · (916) 734-3574
Phone(916) 734-3574
Sole ProprietorYes
Enumeration DateSeptember 2, 2020
Last NPPES UpdateSeptember 30, 20245 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2024
✔ NPI 1457965865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY35369
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2230 STOCKTON BLVD, Sacramento, CA 95817
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mallory Caitlin Kidwell Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95817 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$180.85 typical visit price
range $60.44 – $180.85
Typical copayment $45.21 (range $15.11 – $45.21)
Most-billed visit code 99205
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENATA M BOTELLO
Case Manager/Care Coordinator
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-7251
ANGELICA MARIE LEMELLE VILLALOBOS
Case Manager/Care Coordinator
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-7251
DR. AZMA PARHIN MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-3574
JOSEPHINE SHAYNE LUMAQUIN
Peer Specialist
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-7251
MIGUEL MOLINA
Adult Companion
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-7251
PARIS JORDAN BEAUREGARD DO
Psychiatry & Neurology (Psychiatry)
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-7523
JOHN D RAGLAND P.H.D.
Psychologist
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-2972
DAVID RANDAL HESSL PH.D.
Psychologist
2230 STOCKTON BLVD
SACRAMENTO, CA 95817
Sacramento County (916) 734-2972

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallory Kidwell's NPI number?

The NPI number for Mallory Kidwell is 1457965865. It was assigned to this individual provider in the NPPES registry on September 2, 2020.

Where is Mallory Kidwell located?

Mallory Kidwell practices at 2230 Stockton Blvd, Sacramento, CA 95817. The listed phone number is (916) 734-3574.

What is Mallory Kidwell's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mallory Kidwell enrolled in Medicare?

Yes. Mallory Kidwell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mallory Kidwell was last updated on September 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.