Healthcare Provider Details

I. General information

NPI: 1245779552
Provider Name (Legal Business Name): KRISTIN LYN KAMINSKI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN LYN KAMINSKI PSYD

II. Dates (important events)

Enumeration Date: 02/20/2017
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HIGH ST STE B
AUBURN CA
95603-5151
US

IV. Provider business mailing address

1111 HIGH ST STE B
AUBURN CA
95603-5151
US

V. Phone/Fax

Practice location:
  • Phone: 916-802-3281
  • Fax:
Mailing address:
  • Phone: 916-802-3281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY30967
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY30967
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: