Kelsey Pietro, PSY.D.
Individual provider Active NPI Clinical Psychologist · Carson, CA
NPI 1902303191 · NPPES record last updated Jan 25, 2023
Key facts
- NPI
- 1902303191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 30015 (CA)
- Practice address
- 24436 Island Ave
Carson, CA 90745-6540 - Phone
- (310) 266-7072
- NPI assigned
- Apr 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
24436 Island Ave
Carson, CA 90745-6540
2599 E 28TH St
Suite 206
Signal Hill, CA 90755-2139
Phone (310) 801-2235
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180514001548 | CA | Practitioner - Clinical Psychologist | 8022372374 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelsey Pietro Inc | Clinical | Current |
Accepting new patients |
Locations
2599 E 28th St
Ste 206
Signal Hill, CA 90755
Phone (562) 231-7174
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 30015 | CA | Yes |
Addresses
Primary practice location
24436 Island Ave
Carson, CA 90745-6540
Mailing address
24436 Island Ave
Carson, CA 90745-6540
Other providers in Carson, CA
- An Caye Perreras
- Aimee Cabrera Pestano
- Peters Family Home
- Cynthia Pham
- Katelyn Pham
- Diana E Pineda
- Susana Pineda
- Jillian Ashley Pingel
- Planned Parenthood Los Angeles - Carson Center
- Jennifer Faye Poppy
All providers in Carson, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.