Individual provider Active NPI

Kelly Scheneman, PSY.D.

  • Clinical Psychologist
  • Irvine, CA
National Provider Identifier
1164945002
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34401 Issued in CA
Practice address
16405 Sand Canyon Ave Ste 200
Irvine, CA 92618-3786
Phone
(949) 336-8633
NPI assigned
Jul 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY34401 CA Primary

Addresses

Primary practice location

16405 Sand Canyon Ave Ste 200
Irvine, CA 92618-3786

Mailing address

16405 Sand Canyon Ave Ste 200
Irvine, CA 92618-3786
Phone (949) 336-8633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219001056 CA Practitioner - Clinical Psychologist 0547610479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vivek a Mehta MD IncGroup PAC ID 9830528801, 7 clinicians

Practice addresses (Care Compare)

16300 Sand Canyon Ave
Suite 614
Irvine, CA 92618-3706
Phone (949) 344-3468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY34401CAMDClinical Psychologist

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
Vivek a Mehta MD Inc CurrentSince Dec 1, 2023 Accepting new patients

Locations

16405 Sand Canyon Ave
Ste 200
Irvine, CA 92618
Phone (949) 383-4190

16405 Sand Canyon Ave
Ste 220
Irvine, CA 92618
Phone (949) 336-8150

16300 Sand Canyon Ave
Ste 614
Irvine, CA 92618
Phone (949) 344-3468

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1164945002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16405 SAND CANYON AVE STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183786",
            "telephone_number": "949-336-8633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16405 SAND CANYON AVE STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183786",
            "telephone_number": "949-336-8633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENEMAN",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.