Active NPI
Kelsy Richardson, M.A.
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1518330620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSB94022012
- Practice address
- 2525 Camino del Rio S
Suite 315
San Diego, CA 92108-3717 - Phone
- (612) 248-8606
- NPI assigned
- Nov 11, 2015
- 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 | PSB94022012 | CA | Primary |
Addresses
Primary practice location
2525 Camino del Rio S
Suite 315
San Diego, CA 92108-3717
Mailing address
2525 Camino del Rio S
Suite 315
San Diego, CA 92108-3717
Phone (612) 248-8606
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSB94022012 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447200000000",
"number": "1518330620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 CAMINO DEL RIO S",
"address_2": "SUITE 315",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083717",
"telephone_number": "612-248-8606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 CAMINO DEL RIO S",
"address_2": "SUITE 315",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083717",
"telephone_number": "612-248-8606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "KELSY",
"name_prefix": "Miss",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-11",
"last_updated": "2015-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSB94022012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.