Active NPI
Lynn Kilroy, PH.D.
- Clinical Psychologist
- Santa Monica, CA
National Provider Identifier
1316070964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 15015
- Practice address
- 3101 5TH St Apt 8
Santa Monica, CA 90405-5650 - Phone
- (310) 880-6778
- Fax
- (310) 314-2228
- NPI assigned
- Mar 13, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 15015 | CA | Primary |
Addresses
Primary practice location
3101 5TH St Apt 8
Santa Monica, CA 90405-5650
Mailing address
3019 Ocean Park Blvd # 145
Santa Monica, CA 90405-3004
Phone (310) 446-0888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY 15015 | Other | CA | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 29, 2022 through Apr 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 15015 | CA | MD | Clinical Psychologist |
| 15015 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646179200000",
"number": "1316070964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3019 OCEAN PARK BLVD # 145",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904053004",
"telephone_number": "310-446-0888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 5TH ST APT 8",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904055650",
"telephone_number": "310-880-6778",
"fax_number": "310-314-2228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILROY",
"first_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-13",
"last_updated": "2022-03-02",
"certification_date": "2022-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 15015",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "PSY 15015",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.