Active NPI
Kerry Kathleen De Lima
- Mental Health Counselor
- San Leandro, CA
National Provider Identifier
1548601305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 90298
- Practice address
- 2275 Arlington Dr
San Leandro, CA 94578-1132 - Phone
- (510) 317-1444
- NPI assigned
- Jul 9, 2013
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 90298 | CA | Primary |
| Counselor | 101Y00000X | |||
| Marriage & Family Therapist | 106H00000X | 90298 | CA |
Addresses
Primary practice location
2275 Arlington Dr
San Leandro, CA 94578-1132
Mailing address
2275 Arlington Dr
San Leandro, CA 94578-1132
Phone (510) 317-1444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90298 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452038400000",
"number": "1548601305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2275 ARLINGTON DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781132",
"telephone_number": "510-317-1444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 ARLINGTON DR",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945781132",
"telephone_number": "510-317-1444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LIMA",
"first_name": "KERRY",
"middle_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-09",
"last_updated": "2016-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "90298",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "90298",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.