Individual provider Active NPI

Elizabeth Kennedy

  • Clinical Social Worker
  • Redondo Beach, CA
National Provider Identifier
1083564207
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128216 Issued in CA
Practice address
1725 Harriman LN Apt C
Redondo Beach, CA 90278-4158
Phone
(714) 397-2508
NPI assigned
Jan 28, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 128216 CA Primary

Addresses

Primary practice location

1725 Harriman LN Apt C
Redondo Beach, CA 90278-4158

Mailing address

1725 Harriman LN Apt C
Redondo Beach, CA 90278-4158
Phone (714) 397-2508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
128216CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1769558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1083564207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 HARRIMAN LN APT C",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784158",
            "telephone_number": "714-397-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 HARRIMAN LN APT C",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784158",
            "telephone_number": "714-397-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "128216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; 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.