Kelly A O'Bryan, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY24966 Issued in CA

Practice address

25143 Jack Rabbit Acres
Escondido, CA 92026-1267

Phone

(760) 566-8648

NPI assigned

Nov 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1093882698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25143 JACK RABBIT ACRES",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920261267",
            "telephone_number": "760-566-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25143 JACK RABBIT ACRES",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920261267",
            "telephone_number": "760-566-8648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 E Main St",
            "address_purpose": "LOCATION",
            "city": "El Cajon",
            "state": "CA",
            "postal_code": "920204007",
            "country_code": "US",
            "telephone_number": "619-515-2498",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10065 Old Grove Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921311664",
            "country_code": "US",
            "telephone_number": "858-444-8823 x1232",
            "fax_number": "858-444-8827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRYAN",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "24966",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY24966",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kobryan@comresearch.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "25143 Jack Rabbit Acres",
            "city": "Escondido",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920261267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andres Nunez
• Jose Alberto Nunez
• Sarah Nuterangelo-Van Leuven, APRN, FNP-BC, NP-C
• Jill Nuti, RPH
• Jessica C Nydam, MS, CCC-SLP
• Brenna O'Donnell
• Derek O'Donnell
• Kelly O'Neill
• Therese O'Neill, NMW
• Geraldine O'Sullivan, LCSW, PPSC

• Clinical Psychologist in Escondido, CA
• Providers in Escondido, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.