DR. KELLY M BUSH (NPI# 1649321191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649321191 |
| Entity Type | Individual |
| Full Name | DR. KELLY M BUSH |
| Credential | PSY.D. |
| Practice Address |
710 S Broadway Ste 300 Dept of Mental Health Walnut Creek CA 94596-5229 |
| Practice Telephone | 9252954145 |
| Mailing Telephone | 9252954145 |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2007-07-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 19826 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730550724 | Kelly Bush | Licensed Practical Nurse | 528 Main St, Phoenix, NY 13135-2056 | 2015-10-15 |
| 1114308806 | Kelly Bush | Speech-Language Pathologist | 203 E Tall Oaks Cir, Palm Beach Gardens, FL 33410-4451 | 2015-06-18 |
| 1669955357 | Kelly Bush | Licensed Practical Nurse | 2521 N Elms Rd, Flushing, MI 48433-9423 | 2018-09-10 |
| 1437640158 | Kelly Nicole Bush | Registered Nurse | 651 Colliers Way, Weirton, WV 26062-5053 | 2018-05-29 |
| 1053778787 | Kelly Bush | Nurse Practitioner | 4400 Broadway, Suite 520, Kansas City, MO 64111-3498 | 2016-01-26 |
| 1689060014 | Kelly Bush | Community Health Worker | 32910 W 13 Mile Rd, Bldg. A, Suite 100, Farmington Hills, MI 48334-1980 | 2015-04-13 |
| 1619380250 | Kelly Otisha Bush | Nurse Practitioner | 3240 S Cobb Dr Se, Smyrna, GA 30080-4194 | 2014-06-10 |
| 1073831079 | Kelly Ann Bush | Pediatrics | 3010 Childrens Way, San Diego, CA 92123-4223 | 2010-05-14 |
| 1235384454 | Kelly Bush | Physical Therapy Assistant | 7233 Whipple Ave Nw, North Canton, OH 44720-7137 | 2008-12-02 |
| Street Address |
710 S BROADWAY STE 300 DEPT OF MENTAL HEALTH |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336206721 | Stewart Proctor | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2007-01-03 |
| 1871124222 | Stephanie Gade | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2020-02-03 |
| 1245879725 | Jamie Ashley Williams | Social Worker | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2019-12-31 |
| 1750928354 | Lisa Michelle Walker | Pharmacist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2019-12-03 |
| 1700368974 | Lauren Ellis | Marriage & Family Therapist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2018-09-04 |
| 1659898484 | Anne Rachel Serrano Guijo | Registered Nurse | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2017-08-23 |
| 1225581804 | Shelby Karoline Smith | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2016-07-29 |
| 1467865170 | Alexandra Crockett | Counselor | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2014-06-10 |
| 1225308711 | Matthew Terry Haynes | Social Worker | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2011-12-30 |
| 1730365248 | Catherine Fan Dionisio | Psychologist | 710 S Broadway Ste 300, Walnut Creek, CA 94596-5229 | 2008-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689218216 | Dahlia Magdy | Psychologist | 710 S Broadway Ste 205, Walnut Creek, CA 94596-5233 | 2019-11-06 |
| 1881079648 | Victor Leonard Bernstein | Psychologist | 1225 Alpine Rd #208, Walnut Creek, CA 94596 | 2015-07-22 |
| 1023499068 | Zeinab Mossadeghi | Psychologist | 1910 Olympic Blvd Ste 220, Walnut Creek, CA 94596-5071 | 2015-06-16 |
| 1669896189 | Summit Center | Psychologist | 700 Ygnacio Valley Rd, Suite 320, Walnut Creek, CA 94596-3849 | 2014-02-05 |
| 1093146904 | Randall Kolin | Psychologist | 1600 S Main St Ste 220, Walnut Creek, CA 94596-5376 | 2013-12-02 |
| 1235486523 | Margarita Lorence | Psychologist | 1460 Maria Ln Ste 360, Walnut Creek, CA 94596-8804 | 2012-08-06 |
| 1053603795 | John Lino Gasperoni, Ph.d., Psychologist, P.C. | Psychologist | 3050 Citrus Cir Ste 202, #202, Walnut Creek, CA 94598-2662 | 2011-05-13 |
| 1740589076 | Sharon Muhlenkort | Psychologist | 1204 Alpine Road Suite 4, Walnut Creek, CA 94596 | 2011-03-25 |
| 1174837132 | James W Partington | Psychologist | 311 Lennon Ln Ste A, Walnut Creek, CA 94598-2418 | 2010-08-02 |
| 1548599897 | Patricia Esperanza Zurita Ona | Psychologist | 45 Quail Ct Ste 203, Walnut Creek, CA 94596-8729 | 2009-12-16 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
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| 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.