Individual provider Active NPI

Heidi Castro Kelly, M.A.

  • Marriage & Family Therapist
  • Camarillo, CA
National Provider Identifier
1720225584
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
46480 Issued in CA
Practice address
751 E Daily Dr Ste 320
Camarillo, CA 93010-0772
Phone
(805) 231-6271
NPI assigned
Jan 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 46480 CA Primary

Addresses

Primary practice location

751 E Daily Dr Ste 320
Camarillo, CA 93010-0772

Mailing address

751 E Daily Dr Ste 310
Camarillo, CA 93010-6077
Phone (805) 231-6271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
46480CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Casa Pacifica Centers for Children and Families CurrentSince Jul 4, 2021 Accepting new patients

Locations

1722 S Lewis Rd
Camarillo, CA 93012
Phone (805) 366-4005

751 E Daily Dr
Ste 320
Camarillo, CA 93010
Phone (805) 231-6271

975 Flynn Rd
Camarillo, CA 93012
Phone (805) 388-7740

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1720225584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 E DAILY DR STE 310",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106077",
            "telephone_number": "805-231-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 E DAILY DR STE 320",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930100772",
            "telephone_number": "805-231-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "HEIDI",
        "middle_name": "CASTRO",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2021-06-28",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "46480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.