DR. ANDREA KIRK PH. D
NPI 1760939318
Psychologist in Sebastopol, CA

Active since September 01, 2016PECOS EnrolledAccepts Medicare Assignment
309 S MAIN ST, SEBASTOPOL, CA 95472(707) 939-5475 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Andrea Kirk Ph. D NPPES

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

DR. ANDREA KIRK PH. D (NPI 1760939318) is an individual psychologist in Sebastopol, California and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1760939318
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. ANDREA KIRKCredential: PH. D
Location Address309 S MAIN STSebastopol, CA 95472-4208
Mailing Address309 S Main StSebastopol, CA 95472-4208 · (707) 939-5475
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateSeptember 1, 2016
Last NPPES UpdateFebruary 20, 2024
NPPES CertifiedFebruary 20, 2024
✔ NPI 1760939318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
309 S MAIN ST, Sebastopol, CA 95472

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Andrea Kirk Ph. D is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810272812
PECOS Enrollment IDI20170313002017
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.

Medicare Billing Reassignment

Medicare enrollment records show Andrea Kirk reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Same address
Clinical
309 S MAIN ST
Sebastopol, CA 95472
  • Reassigned Medicare billing, California enrollment

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 2

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

Psychologist (Clinical)
309 S MAIN ST
SEBASTOPOL, CA 95472
Naturopath
309 S MAIN ST
SEBASTOPOL, CA 95472

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 Andrea Kirk's NPI number?

The NPI number for Andrea Kirk is 1760939318. It was assigned to this individual provider in the NPPES registry on September 1, 2016.

Where is Andrea Kirk located?

Andrea Kirk practices at 309 S Main St, Sebastopol, CA 95472. The listed phone number is (707) 939-5475.

What is Andrea Kirk's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Andrea Kirk enrolled in Medicare?

Yes. Andrea Kirk is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Andrea Kirk's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Kirk reassigns Medicare benefits to Andrea E Kirk Phd (Sebastopol, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrea Kirk's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Andrea Kirk was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.