Kelly O'Brien, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

103045 Issued in CA

Practice address

3680 E Imperial Hwy Ste 220
Lynwood, CA 90262-2663

Phone

(323) 769-7174

NPI assigned

Mar 8, 2013

Last updated

Nov 23, 2021By the provider in NPPES

Sex

Female

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1336458934
  NPD (past)
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1710132691
  NPD (past)

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1417298977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 E IMPERIAL HWY STE 220",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622663",
            "telephone_number": "323-769-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 E IMPERIAL HWY STE 220",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902622663",
            "telephone_number": "323-769-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-08",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103045",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "0816521",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nueva Vision Optical
• Bernardino Nunez, PTA
• Grecia Veronica Nunez
• Michelle Nunez
• Cailin Frances O'Brien, ACSW
• Vanessa O'Neill
• Chinwe Obi-Canby
• Occupational Health Service Medical Group Inc.
• Yvonne Ochoa
• Odette R Tawadrous Medical Clinic Inc.

• Clinical Social Worker in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.

Verify at the official NPI Registry.