Cecily Kaballo, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY30477 Issued in CA

Practice address

152 S Swall Dr
Beverly Hills, CA 90211-2611

Phone

(310) 957-9248

NPI assigned

Aug 7, 2015

Last updated

Jun 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1164808523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 S SWALL DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112611",
            "telephone_number": "310-957-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 S SWALL DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112611",
            "telephone_number": "310-957-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABALLO",
        "first_name": "CECILY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY30477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.psychologytoday.com/profile/761481",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Beverly Hills",
            "address_1": "152 S Swall Dr",
            "city": "Beverly Hills",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902112611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Justin Yovino MD PA (Ideal Face and Body)
• K and B Surgical Center
• K and B Surgical Group, LLC
• K Surgical Center, Inc.
• K. Alex Kim, M.D., a Medical Corporation (Brooks Surgery Center Medical Associates)
• Reem Kabbarah, DDS
• Ramona Kadkhodazadeh, PHARM D
• Bruce B Kadz, M.D
• Peyman Kafri, D.M.D.
• Kagan Psychiatry

• Clinical Psychologist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.