DR. KELLY HWA KOO (NPI# 1740521970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740521970 |
| Entity Type | Individual |
| Full Name | DR. KELLY HWA KOO |
| Credential | PH.D. |
| Practice Address |
1001 Sneath Ln Suite 300 San Bruno CA 94066-2308 |
| Practice Telephone | 6506156075 |
| Mailing Telephone | 6506156075 |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2016-01-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY27845 | CA | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| Street Address |
1001 SNEATH LN SUITE 300 |
| City | SAN BRUNO |
| State | CA |
| Zip Code | 94066-2308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710082201 | Kathleen Yvonne Bennett | Social Worker | 1001 Sneath Ln, Suite 300, San Bruno, CA 94066-2308 | 2006-09-13 |
| 1033732573 | Jenny Estrada | Counselor | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2020-05-19 |
| 1144870577 | Matthew Oliver Dimabuyu | Behavior Technician | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-09-17 |
| 1649823923 | Maxwell Khanin | Psychologist | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-07-16 |
| 1326690462 | Jada Faye Chappel | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-07-09 |
| 1164085304 | Raymond J Taboada Jr. | Counselor | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-04-14 |
| 1962966390 | Mary Frances Granados | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-01-30 |
| 1902379878 | Dan Navarro | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2019-01-03 |
| 1689144024 | Kacey Lauren Lilly | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2018-11-28 |
| 1730658675 | Melissa Alvarez | Behavioral Analyst | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2018-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1568018406 | Susan Page Gadegone | Community Health Worker | 931 San Bruno West Avenue Suite 2, San Bruno, CA 94066 | 2019-08-15 |
| 1184198780 | Sonya Oey Kramer | Pharmacist | 10 Bayhill Drive, San Bruno, CA 94066 | 2019-01-16 |
| 1316410350 | Brennen Marques Mcdowell | Behavioral Analyst | 101 Sneath Lane Ste. 200, 200, San Bruno, CA 94066 | 2019-01-02 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| 1275921231 | C & C's Care Home | Assisted Living Facility | 2700 Oakmont Dr., San Bruno, CA 94066 | 2014-12-29 |
| Find all providers in zip 94066 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578620464 | Ori Kochavi | Psychologist | 801 Traeger Ave Ste 209, Kaiser - Dept. of Child & Adolescent Psychiatry, San Bruno, CA 94066-3048 | 2007-01-02 |
| 1235235821 | Dr Oscar F Cervantes Clinical Psychologist Inc | Psychologist | 715 El Camino Real # 210, San Bruno, CA 94066 | 2006-09-15 |
| 1104298603 | Nathan Ewigman | Psychologist | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2015-10-22 |
| 1629224878 | Oscar F. Cervantes | Psychologist | 715 El Camino Real, #209, San Bruno, CA 94066-3426 | 2008-08-07 |
| 1750429932 | Mario Alberto Sandoval | Psychologist | 1100 Grundy Ln, San Bruno, CA 94066-3065 | 2007-02-01 |
| 1831244458 | Bradley Alan Siu | Psychologist | 801 Traeger Ave, 209, San Bruno, CA 94066-3048 | 2007-01-24 |
| 1841341534 | Eric Scott Hooe | Psychologist | 1001 Sneath Ln, Suite 204, San Bruno, CA 94066-2308 | 2007-01-16 |
| 1023167665 | April C. Vogensen-cascao | Psychologist | 801 Traeger Ave, Kaiser Child Psychiatry, 2nd Floor, San Bruno, CA 94066-3048 | 2007-01-10 |
| 1619033248 | Kathleen Anne Mulherin | Psychologist | 1001 Sneath Ln, Suite 204, San Bruno, CA 94066-2308 | 2006-12-28 |
| 1508926783 | Kate Jane Riley | Psychologist | 1001 Sneath Ln, San Bruno, CA 94066-2308 | 2006-12-11 |
| Find all providers in SAN BRUNO | ||||
Please comment or provide details below to improve the information on DR. KELLY HWA KOO.
| 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.