Gabrielle Kennedy, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

25432 Issued in CA

Practice address

880 Third Ave
Chula Vista, CA 91911-1305

Phone

(619) 205-4585

NPI assigned

Dec 18, 2024

Last updated

Dec 18, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Centro de Salud de la Comunidad de San Ysidro Inc

  dba San Ysidro Health Senior Dental Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1457033813
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba San Ysidro Health Precision Park

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1124782685
  NPD
• Centro de Salud de la Comunidad de San Ysidro, Inc.

  dba General Physician Group Multi Specialty

  • Federally Qualified Health Center (FQHC)
  • San Ysidro, CA
  • NPI 1164641965
  NPD

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1194532523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 CHEROKEE AVE APT 8",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921043154",
            "telephone_number": "303-521-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 THIRD AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111305",
            "telephone_number": "619-205-4585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921055424",
            "country_code": "US",
            "telephone_number": "619-263-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "GABRIELLE",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "25432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim My Kelly, OD
• Walter Kelly, H.I.S.
• Kelsey Barbieri, Licensed Clinical Social Worker, a Professional Corp (Unwind Your Mind Therapy)
• Jordan Dean Wingfield Keltner
• Brian Anthony Kendrick, LCSW
• Jack Dylan Kennedy, RD
• Kenneth a. Romero, M.D., Inc
• Pamela Louise Kenney, M.D.
• Vivian Nishan Keorhagian
• Keri D.D.S a Professional Corporation

• Occupational Therapist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.