KIMBERLY MARIE HAGAN PHD
NPI 1861584922
Psychologist - Clinical in Fullerton, CA

Q: What is Kimberly Hagan's NPI number?

The NPI number for Kimberly Hagan is 1861584922. It was assigned to this individual provider in the NPPES registry on September 28, 2006.

Q: What is Kimberly Hagan's specialty?

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

Q: Is Kimberly Hagan enrolled in Medicare?

No. Kimberly Hagan has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Hagan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since September 28, 2006Opted out of Medicare · through Oct 1, 2027

2228 N STATE COLLEGE BLVD, FULLERTON COUNSELING & MEDICAL GROUP INC, FULLERTON, CA 92831(714) 990-0700(714) 990-0142 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kimberly Marie Hagan Phd NPPES

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

KIMBERLY MARIE HAGAN PHD (NPI 1861584922) is an individual clinical provider in Fullerton, California, licensed in California (PSY15282) and active in the NPI registry since September 2006. She has opted out of Medicare through October 1, 2027.

NPPES Registry Identity

NPI1861584922

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameKIMBERLY MARIE HAGANCredential: PHD

Location Address2228 N STATE COLLEGE BLVD, FULLERTON COUNSELING & MEDICAL GROUP INCFullerton, CA 92831

Mailing Address2228 N State College Blvd, Fullerton Counseling & Medical Group IncFullerton, CA 92831 · (714) 990-0700 · Fax (714) 990-0142

Phone(714) 990-0700

Fax(714) 990-0142

Sole ProprietorNo

Enumeration DateSeptember 28, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1861584922 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 · PSY15282

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.

2228 N STATE COLLEGE BLVD, Fullerton, CA 92831

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Other Identifiers 1

Medicare ID-Type UnspecifiedCP15282

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kimberly Marie Hagan Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2021 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2021

Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 5

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

RICHARD A FRY PH.D.

Psychologist (Clinical)