Kelley Ha, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT35635-TLG Issued in CA

Practice address

15315 Magnolia Blvd Ste 100
Sherman Oaks, CA 91403-1173

Phone

(805) 230-2126

Fax

(805) 230-2199

NPI assigned

Feb 20, 2024

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment
• Aericks Medical Clinic Inc

  dba Aericks Healthcare Clinic

  • Family Medicine Physician
  • Inglewood, CA
  • NPI 1982588737
  NPD (past)
• Diane Tran, O.D., Inc.

  • Optometrist
  • Lakewood, CA
  • NPI 1174205439
  NPD (past)
• Rajesh Khanna a Medical Corporation

  • Ophthalmology Physician
  • Corona, CA
  • NPI 1598944332
  NPD (past)

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1649035312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13621 IOWA ST",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926832639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15315 MAGNOLIA BLVD STE 100",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031173",
            "telephone_number": "805-230-2126",
            "fax_number": "805-230-2199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 W Los Angeles Ave Ste 111",
            "address_purpose": "LOCATION",
            "city": "Moorpark",
            "state": "CA",
            "postal_code": "930214218",
            "country_code": "US",
            "telephone_number": "805-529-5497",
            "fax_number": "805-230-2199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "645 Aerick St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903014883",
            "country_code": "US",
            "telephone_number": "310-677-7108",
            "fax_number": "805-230-2199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HA",
        "first_name": "KELLEY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35635-TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yamileth Guadalupe Gutierrez
• Yareli Gutierrez
• Ryan Gutterson-Cahill, B.C.B.A.
• Kaitlin Rose Guzman
• Ha Decisions Hospice Inc
• Cecile Habash
• Angela Hagopian, M.A.
• Amna Haider, LMFT
• Brooke Hailey, PHD, MFT
• Ryan Jacob Haimof, DDS

• Optometrist in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.