Individual provider Active NPI

Kelly Barclay, PSY.D.

  • Clinical Psychologist
  • Huntington Beach, CA
National Provider Identifier
1255404299
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY15591 Issued in CA
Practice address
16152 Beach Blvd
Suite 170
Huntington Beach, CA 92647-3806
Phone
(714) 841-9940
Fax
(714) 847-8909
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY15591 CA Primary

Addresses

Primary practice location

16152 Beach Blvd
Suite 170
Huntington Beach, CA 92647-3806

Mailing address

16152 Beach Blvd
Suite 170
Huntington Beach, CA 92647-3806
Phone (714) 841-9940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2015 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15591CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255404299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16152 BEACH BLVD",
            "address_2": "SUITE 170",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473806",
            "telephone_number": "714-841-9940",
            "fax_number": "714-847-8909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16152 BEACH BLVD",
            "address_2": "SUITE 170",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473806",
            "telephone_number": "714-841-9940",
            "fax_number": "714-847-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARCLAY",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.