Active NPI
Starr Kelton-Locke
- Psychologist
- Kentfield, CA
National Provider Identifier
1003265760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY16108
- Practice address
- 1030 Sir Francis Drake Blvd
Ste. 100
Kentfield, CA 94904-1411 - Phone
- (415) 453-2782
- Fax
- (415) 457-9932
- NPI assigned
- Jun 3, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY16108 | CA | Primary |
Addresses
Primary practice location
1030 Sir Francis Drake Blvd
Ste. 100
Kentfield, CA 94904-1411
Mailing address
1030 Sir Francis Drake Blvd
Ste. 100
Kentfield, CA 94904-1411
Phone (415) 453-2782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 15, 2024 through Nov 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY16108 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1003265760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 SIR FRANCIS DRAKE BLVD",
"address_2": "STE. 100",
"city": "KENTFIELD",
"state": "CA",
"postal_code": "949041411",
"telephone_number": "415-453-2782",
"fax_number": "415-457-9932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 SIR FRANCIS DRAKE BLVD",
"address_2": "STE. 100",
"city": "KENTFIELD",
"state": "CA",
"postal_code": "949041411",
"telephone_number": "415-453-2782",
"fax_number": "415-457-9932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELTON-LOCKE",
"first_name": "STARR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-03",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY16108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.