Joseph Kelly, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30307 Issued in CA

Practice address

228 W Main St
Tustin, CA 92780-4320

Phone

(949) 558-4925

NPI assigned

Mar 30, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2026 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Alinea Behavioral Health

  • Clinical Psychologist
  • Fullerton, CA
  • NPI 1255996245
  NPD (past)
• Joseph Mauch

  • Clinical Psychologist
  • Mill Valley, CA
  • NPI 1619435864
  NPD (past)

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1306209150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 W MAIN ST",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804320",
            "telephone_number": "916-715-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W MAIN ST",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804320",
            "telephone_number": "949-558-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "30307",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Norman Kausler DC Inc-a
• Tina Keith
• Jamie Keller, M.A.
• Megan Renee Keller, LMFT
• Kelly Tran Optometry, Inc
• Michael Sean Kelly, NP
• John A Kennedy, BCO
• Ariana Kenney
• Judith A Kent, PH.D.
• Keon-Jung Kim Dental Corporation

• Clinical Psychologist in Tustin, CA
• Providers in Tustin, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.