Christina Ann Kelly

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PT35091 Issued in CA

Practice address

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821

Phone

(323) 751-3726

NPI assigned

Oct 28, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1972267615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "323-751-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "323-751-3726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Motor Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900343740",
            "country_code": "US",
            "telephone_number": "310-836-1223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "CA",
            "license": "PT35091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Kelly-Latzer
• Alison Scott Kelly, M.S., R.D.
• Aubrey Derrick Kelly
• Brenna Michelle Kelly
• Carol Ann Kelly, ED.D.
• El'Lina Janay Kelly
• Emma Kelly
• Enda Kelly, MD
• Erin Kelly, PHD
• Erin Shigeko Kelly, M.D.

• Licensed Psychiatric Technician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Licensed Psychiatric Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.