Active NPI
Kelly Psychological Group, Inc.
- Clinical Psychologist
- Tustin, CA
National Provider Identifier
1538068945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- KELLY PSYCHOLOGICAL GROUP, INC.
- Practice address
- 228 W Main St RM 4
Tustin, CA 92780-4320 - Phone
- (714) 752-3692
- NPI assigned
- Nov 3, 2026
- Last updated
- Nov 3, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joseph Kelly, PHD
- Title
- President
- Phone
- (714) 752-3692
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
228 W Main St RM 4
Tustin, CA 92780-4320
Mailing address
228 W Main St RM 4
Tustin, CA 92780-4320
Phone (714) 752-3692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1793664000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1793664000000",
"number": "1538068945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 W MAIN ST RM 4",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927804320",
"telephone_number": "714-752-3692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 W MAIN ST RM 4",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927804320",
"telephone_number": "714-752-3692"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KELLY PSYCHOLOGICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2026-11-03",
"last_updated": "2026-11-03",
"certification_date": "2026-11-03",
"status": "A",
"authorized_official_last_name": "KELLY",
"authorized_official_first_name": "JOSEPH",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "714-752-3692",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.