Sharon Kelly, PH.D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PSY9811 Issued in CA

Practice address

3020 Old Ranch Pkwy
Ste 300
Seal Beach, CA 90740-2751

Phone

(562) 430-5144

NPI assigned

Feb 23, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Southland Neurologic Associates

  • Neurology Physician
  • Long Beach, CA
  • NPI 1245587070
  NPD (past)
• Memorial Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1255523643
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1215062658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 OLD RANCH PKWY",
            "address_2": "STE 300",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402751",
            "telephone_number": "562-430-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 OLD RANCH PKWY",
            "address_2": "STE 300",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402751",
            "telephone_number": "562-430-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHARON",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSY9811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Frederick Kaplan, D.D.S.
• Karol a Bailey, PH.D., a Professional Psychological Corporation
• Lana Kashou
• Shauna Marie Kaufman, RBT, BCBA
• Keith W. Cowhey, DDS, Inc
• Keystone Pediatric Behavioral Health
• Andrew Kim, DDS
• David Kim, PT, DPT
• Hyunmie Lee Kim, NP
• Johnathan Yoon-Young Kim, LVN

• Mental Health Counselor in Seal Beach, CA
• Providers in Seal Beach, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.