Kelly Elizabeth Walsh, MS, ATC, LAT, PES

Primary specialty

SpecialistTaxonomy code 174400000X

License

NATABOC 08012030

Practice address

University of California Santa Barbara
Department of Intercollegiate Athletics, Ica Building
Santa Barbara, CA 93106-5200

Phone

(805) 893-3424

Fax

(805) 893-5420

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1629285689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 E. SKELTON CANYON CIR.",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF CALIFORNIA SANTA BARBARA",
            "address_2": "DEPARTMENT OF INTERCOLLEGIATE ATHLETICS, ICA BUILDING",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931065200",
            "telephone_number": "805-893-3424",
            "fax_number": "805-893-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MS, ATC, LAT, PES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "AH1421-AT",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "NATABOC 08012030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn M Wall
• Eric Michael Wallace, DDS
• Maureen L Wallace, AU
• Meghan M Wallman, MD
• George Reynolds Walseth I, DDS
• Rachel Walsh
• Christopher Walstead, PT, ATC
• Walter C Dukes DDS a Professional Corporation
• Maria Elly Walters-Bible, RN, BSN, PHN
• Eric Walters, DDS

• Specialist in Santa Barbara, CA
• Providers in Santa Barbara, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; 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.