Kelly Warren, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY27851 Issued in CA

Practice address

2447 Pacific Coast Hwy Ste 213
Hermosa Beach, CA 90254-2714

Phone

(310) 947-9279

NPI assigned

May 7, 2014

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Beach PsychologyGroup PAC ID 8022315084, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Beach Psychology

  • Psychologist
  • Hermosa Beach, CA
  • NPI 1528423654
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1891105193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2447 PACIFIC COAST HWY STE 213",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542714",
            "telephone_number": "310-947-9279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2447 PACIFIC COAST HWY STE 213",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542714",
            "telephone_number": "310-947-9279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARREN",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY27851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Deanne Waldman, PH.D.
• Kacey Walker, AMFT
• Mignon Walker, MD
• Steven V Walker Jr., APCC
• Jennifer Patricia Walsh, ED.D
• Way of the Tao, Acupuncture & Wellness Inc.
• John Anthony Webber, MS, LMFT
• Carol G Weiss, PHD
• Wellness Physical Therapy, Inc.
• Raylen T Wells

• Psychologist in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.