Rebecca Kennedy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

95510 Issued in CA

Practice address

3435 Ocean Park Blvd Ste 207
Santa Monica, CA 90405-3314

Phone

(323) 895-3139

NPI assigned

Sep 9, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Step Up on Second Street Inc.

  dba Step Up on Second-San Bernardino

  • Community/Behavioral Health Agency
  • San Bernardino, CA
  • NPI 1285186353
  NPD (past)
• Step Up on Second Street, Inc.

  dba Step Up on Second Street-FCCS Plus

  • Community/Behavioral Health Agency
  • Santa Monica, CA
  • NPI 1891825451
  NPD (past)

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1629525464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 OCEAN PARK BLVD STE 207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053314",
            "telephone_number": "323-895-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 OCEAN PARK BLVD STE 207",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904053314",
            "telephone_number": "323-895-3139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 N Kings Rd",
            "address_2": "Apt 2",
            "address_purpose": "LOCATION",
            "city": "West Hollywood",
            "state": "CA",
            "postal_code": "900482118",
            "country_code": "US",
            "telephone_number": "617-281-3297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "95510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen J. Kenneally, MBA, MA, MFT
• Allison Paige Kennedy, MD
• Elizabeth Anne Kennedy, MA, AMFT
• Hannah Elise Kennedy, PA-C
• Nicole Katelyn Kennedy, LMFT
• Maureen Catherine Kenny
• Kim Kensington, PSY.D.
• Ivanna Lynn Kenwood, DPM
• Kathleen Keogh
• Russell B Kerbel

• Clinical Social Worker in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; 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.