Kathleen Ann Kelly, PHD

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

DRH01006488 Issued in CA

Practice address

David Geffen Medical Ctr UCLA 10833 Le Conte Ave
Mailroom A3-215 CHS, Mailcode 173216
Los Angeles, CA 90095-1732

Phone

(310) 206-5562

Fax

(310) 794-4863

NPI assigned

Oct 17, 2016

Last updated

Oct 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1699226415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DAVID GEFFEN MEDICAL CTR UCLA 10833 LE CONTE AVE",
            "address_2": "MAILROOM A3-215 CHS, MAILCODE 173216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951732",
            "telephone_number": "310-206-5562",
            "fax_number": "310-794-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DAVID GEFFEN MEDICAL CTR UCLA 10833 LE CONTE AVE",
            "address_2": "MAILROOM A3-215 CHS, MAILCODE 173216",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900951732",
            "telephone_number": "310-206-5562",
            "fax_number": "310-794-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "DRH01006488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Kelly, L.AC.
• James Aaron Kelly, DDS., MS
• Janessa Kelly
• John Patrick Kelly, M.D.
• Kanoa Kelly
• Kathleen Marie Kelly, B.C.B.A
• Kevin R. Kelly, M.D.
• Kim-Sa Kelly, DDS
• Kimberly Kelly, M.D.
• Laurence Kelly

• Clinical Medical Laboratory in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.