Theresa Ann Redondo Kennedy, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60436 Issued in CA

Practice address

2425 Enborg LN
San Jose, CA 95128-2648

Phone

(408) 885-4077

NPI assigned

Jun 18, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Tracy Ann Kennedy Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1073718334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 ENBORG LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282648",
            "telephone_number": "408-885-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 ENBORG LN",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282648",
            "telephone_number": "408-885-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "THERESA",
        "middle_name": "ANN REDONDO",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "60436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "KENNEDY",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "MSW, LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Benjamin Duncan Kennedy
• Erin S Kennedy, M.S.
• Jessica Nicholl Kennedy, RN
• Kaitlyn Kennedy, DPT
• Paul Byron Kennedy, MD
• Shelley Jean Kenner
• Kenneth H. Ballentine OD Inc.
• Kenneth S. Blumenfeld, MD. P.C.
• Kenneth V. Hoang, DMD, Inc
• Kenneth Y. Kai, DDS, Inc

• Clinical Social Worker in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.