Kimberly Pelle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

92672 Issued in CA

Practice address

5601 De Soto Avenue
Woodland Hills, CA 91367

Phone

(424) 241-8243

NPI assigned

Apr 28, 2020

Sex

Female

Sole proprietor

Yes

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)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: kimberlypelle@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1477174753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3888",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "91394",
            "telephone_number": "424-241-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 DE SOTO AVENUE",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "91367",
            "telephone_number": "424-241-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLE",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "92672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexus Marie Pedro
• Abigail Pedroza
• Elizett Anahi Pedroza
• Abraham Peinado
• Pejman Bahari-Nejad, D.O., a Professional Medical Corporation
• Tomas Camilo Pelliccione
• Janice B Pellico, M.A.,CCC
• Keila Pena Basave
• Alexandro Pena
• Lorraine J. Pena, MD

• Clinical Social Worker in Woodland Hills, CA
• Providers in Woodland Hills, 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 Mar 29, 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.