Kelly Bermingham, MA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

914 Calle Venezia
San Clemente, CA 92672-6039

Phone

(194) 968-3775

NPI assigned

Feb 14, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Kelly McKinnon & Associates, Inc.

  • Behavior Analyst
  • San Juan Capistrano, CA
  • NPI 1245579374
  NPD (past)

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1386984136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27452 CALLE ARROYO",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 CALLE VENEZIA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926726039",
            "telephone_number": "194-968-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13920 City Center Dr Ste 290",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917095444",
            "country_code": "US",
            "telephone_number": "186-635-1888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMINGHAM",
        "first_name": "KELLY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-14",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Engy Bebaway, PHARM.D.
• Faith Elizabeth Bechtel
• Gwendolyn Bellezza, M.A., CCC-SLP
• Brian Douglas Benjamin, D.D.S.
• Criag R Bergquist, DDS
• Brianna Bern
• Miki Bernal, MA, OT/L, CHT
• Edward Horacio Bestard, M.D., F.A.C.S.
• Beth Anderson LMFT
• Beth Holder Licensed Marriage and Family Therapy Inc

• All providers in San Clemente, CA
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.