Kenrick Licorish Medical Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

KENRICK LICORISH MEDICAL CORPORATION

Practice address

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140

Phone

(408) 384-3758

NPI assigned

Mar 31, 2023

Last updated

Jun 14, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenrick Brian LicorishNPI 1144759085

Title

Practice Owner, Psychiatrist

Phone

(408) 384-3758

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenrick Brian Licorish, MD

  • Psychiatry Physician
  • Santa Clara, CA
  • NPI 1144759085
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749859200000",
    "number": "1518662485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 S COAST HWY # 2623",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926513681",
            "telephone_number": "408-384-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 GREAT AMERICA PKWY STE 320",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950541140",
            "telephone_number": "408-384-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENRICK LICORISH MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A",
        "authorized_official_last_name": "LICORISH",
        "authorized_official_first_name": "KENRICK",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRACTICE OWNER, PSYCHIATRIST",
        "authorized_official_telephone_number": "408-384-3758"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuyen Huynh Kemp, D.P.M.
• Katherine Kempkey, PT, DPT
• Brittany Jasmine Kendall
• Prachi Mahesh Keni-McCray, MD
• Kenneth Hu
• Christina Marie Kerwin, AU.D.
• Saranya Kesavaviswanathan
• Karolin Elsabea Kettler, MA
• Irina Khachatryan, MD
• Orod Khaghani, MD

• Psychiatry Physician in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.