DR. MARY PAT KELLY (NPI# 1235348509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235348509 |
| Entity Type | Individual |
| Full Name | DR. MARY PAT KELLY |
| Credential | PH.D. |
| Practice Address |
380 Glenneyre St Ste D Laguna Beach CA 92651-2303 |
| Practice Telephone | 9494940093 |
| Practice Fax Number | 9494970913 |
| Mailing Telephone | 9494940093 |
| Mailing Fax Number | 9494970913 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY12662 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558844811 | Mary Elizabeth Kelly | Social Worker | 97 Libbey Industrial Pkwy Ste 301, Weymouth, MA 02189-3110 | 2018-09-12 |
| 1215410790 | Mary Jane Kelly | Dietitian, Registered | 1046 E Elgenia Ave, West Covina, CA 91790-1318 | 2018-09-11 |
| 1073020590 | Mary Teresa Kelly | Counselor | 726 Cherryvale Rd, Boulder, CO 80303-2911 | 2018-01-05 |
| 1972040459 | Mary A Kelly | Registered Nurse | 116 N Lake Ave, Albany, NY 12206-2710 | 2017-01-23 |
| 1073904215 | Mary Kelly | Registered Nurse | 3145 State Route 718, Troy, OH 45373-8908 | 2015-02-10 |
| 1174924054 | Mary Kelly | Nurse Practitioner | 14435 15th Ave, Whitestone, NY 11357-2407 | 2014-09-10 |
| 1306058714 | Mary Catherine Kelly | Nurse Practitioner | 275 Riverside Ave, Riverside, CT 06878-2313 | 2007-05-06 |
| 1134340086 | Mary Kris Kelly | Nurse Practitioner | 1 Gustave L Levy Pl # 1030, New York, NY 10029-6500 | 2007-05-01 |
| 1518187772 | Mary Ann Kelly | Dietary Manager | 6448 Hallee Rd Ste 9, Joshua Tree, CA 92252-1908 | 2007-04-27 |
| 1003036583 | Mary Anne Kelly | Marriage & Family Therapist | 105 Sunnyside Ave, Piedmont, CA 94611-4419 | 2007-04-26 |
| Street Address |
380 GLENNEYRE ST STE D |
| City | LAGUNA BEACH |
| State | CA |
| Zip Code | 92651-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043235369 | Marianne Ross | Psychologist | 380 Glenneyre St Ste D, Laguna Beach, CA 92651-2303 | 2006-07-13 |
| 1548596885 | Jessica Drew De Paz | Psychologist | 380 Glenneyre St Ste D, Laguna Beach, CA 92651-2303 | 2009-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856073 | Ocean View Neuropsychiatry | Psychiatry & Neurology | 31862 Coast Highway Unit 302, Laguna Beach, CA 92651 | 2019-11-25 |
| 1871154526 | Jinyi Bae | Psychiatry & Neurology | 31872 Coast Highway, Behavioral Health Unit, Laguna Beach, CA 92651 | 2019-06-24 |
| 1790348209 | Karen Veseth | Pharmacist | 30842 South Pacific Coast Highway, Laguna Beach, CA 92651 | 2019-04-19 |
| 1629536602 | Briana Kim | Pharmacist | 30842 S Pacific Coast Highway, Laguna Beach, CA 92651 | 2019-03-08 |
| 1295246288 | Priscilla Newton | Marriage & Family Therapist | 1427 Catalina, Laguna Beach, CA 92651 | 2017-10-17 |
| 1659723609 | Kassie Claughton | Social Worker | 1986 S Coast Hwy, Suite 1600, Laguna Beach, CA 92651 | 2016-07-01 |
| 1285029629 | Kathleen Susan Wenger | Counselor | 1550 South Pacific Coast Highway, #205, Laguna Beach, CA 92651 | 2015-04-02 |
| 1316350044 | Marcus D Yetter | Podiatrist | 31852 Coast Hwy Ste 105, Laguna Beach, CA 92651 | 2014-06-10 |
| 1891105854 | Connie Lee Bird | Social Worker | 332 Forest Ave #21, Laguna Beach, CA 92651 | 2014-04-30 |
| 1578989745 | Ana Maria Guerrero | Acupuncturist | 1100 South Coast Highway # 215, Laguna Beach, CA 92651 | 2014-03-12 |
| Find all providers in zip 92651 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740612043 | Lanique G Ruffin | Psychologist | 1968 S Coast Hwy Ste 1188, Laguna Beach, CA 92651-3681 | 2013-08-08 |
| 1558636183 | Bernard Sherman Schwartz | Psychologist | 1045 Balboa Ave, Laguna Beach, CA 92651-3839 | 2012-03-15 |
| 1104020189 | Kay Wickett Ostensen | Psychologist | 1278 Glenneyre, Psychology Center #d, Laguna Beach, CA 92651 | 2007-06-13 |
| 1215138391 | Dale W Oneal | Psychologist | 266 Grandview St, Laguna Beach, CA 92651-1519 | 2007-05-29 |
| 1538382940 | Amy Hardwick | Psychologist | 459 Hill St, Laguna Beach, CA 92651-1888 | 2007-04-11 |
| 1043433469 | Marion K. Jacobs | Psychologist | 2060 Temple Hills Dr, Laguna Beach, CA 92651-2660 | 2007-04-11 |
| 1528192184 | Jennifer Lynn Barron | Psychologist | 1278 Glenneyre Street, Suite 30, Laguna Beach, CA 92651 | 2007-03-15 |
| 1679600027 | Lyda Hill | Psychologist | 21622 Ocean Vista Dr, Laguna Beach, CA 92651 | 2007-02-27 |
| 1790860674 | Patrick F Aleknavicius | Psychologist | 352 3rd St Ste 308, Laguna Beach, CA 92651-2357 | 2006-10-26 |
| 1699857292 | Nancy D. Mcgovern | Psychologist | 21632 Wesley Dr, Laguna Beach, CA 92651-8167 | 2006-10-20 |
| Find all providers in LAGUNA BEACH | ||||
| City | LAGUNA BEACH |
| Zip Code | 92651 |
Please comment or provide details below to improve the information on DR. MARY PAT KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.