Active NPI
Colleen Kelley, OTR/L
- Occupational Therapist
- Long Beach, CA
National Provider Identifier
1346659604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14470
- Practice address
- 218 Redondo Ave Apt 7
Long Beach, CA 90803-5903 - Phone
- (401) 787-5878
- NPI assigned
- Aug 11, 2014
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 14470 | CA | Primary |
Addresses
Primary practice location
218 Redondo Ave Apt 7
Long Beach, CA 90803-5903
Mailing address
218 Redondo Ave Apt 7
Long Beach, CA 90803-5903
Phone (401) 787-5878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14470 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1346659604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 REDONDO AVE APT 7",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908035903",
"telephone_number": "401-787-5878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 REDONDO AVE APT 7",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908035903",
"telephone_number": "401-787-5878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLEY",
"first_name": "COLLEEN",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-11",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "14470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.