Active NPI
Monica Rae Kelly
- Clinical Psychologist
- North Hills, CA
National Provider Identifier
1376114355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY37810
- Practice address
- 16111 Plummer St
North Hills, CA 91343-2036 - Phone
- (818) 891-7711
- NPI assigned
- Jul 9, 2021
- Sex
- Female
- Sole proprietor
- No
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 | PSY37810 | CA | Primary |
Addresses
Primary practice location
16111 Plummer St
North Hills, CA 91343-2036
Mailing address
PO Box 950253
Mission Hills, CA 91395-0253
Phone (520) 261-1166
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY37810 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628208000000",
"number": "1376114355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 950253",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913950253",
"telephone_number": "520-261-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16111 PLUMMER ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913432036",
"telephone_number": "818-891-7711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MONICA",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-09",
"last_updated": "2021-08-06",
"certification_date": "2021-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY37810",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.