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Kellsie Lin Davis

Social Worker β€’ Orange, CA

Active NPI 1528437043 Individual Practitioner Female Practitioner
Practice location in NPPES

401 S Tustin St Bldg D
Orange, CA 928662550

Call 7142893936 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

401 S Tustin St Bldg D

Orange, CA 928662550

Telephone 7142893936
Organization at the Same NPPES Address or Phone
Stars Behavioral Health Group Inc Facility NPI 1215551890

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2015

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Orange and California

107 active clinicians are listed under Social Worker with a practice address in Orange, CA (10,337 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Orange

0% of these 107 clinicians have the CMS telehealth indicator.

0.9% of these 107 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-05-31
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

License # reported to NPPES CA LCSW121225

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Medical Board of California.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Anthony Conciatori , DO

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1982838900

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

15 Historical Events
πŸ“
Updated Practice Location May 31, 2024

Registered at 401 S TUSTIN ST BLDG D, ORANGE, CA 928662550 (Tel: 7142893936)

πŸ“
Updated Business Mailing Address May 31, 2024

Registered at 401 S TUSTIN ST BLDG D, ORANGE, CA 928662550 (Tel: 7142893936)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 31, 2024

Social Worker (license number reported to NPPES: CA LCSW121225)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2018

Social Worker (license number reported to NPPES: CA ACSW77255)

βœ…
NPI Profile Active February 07, 2018

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location February 07, 2018

Registered at 4025 W 226TH ST, TORRANCE, CA 905052340 (Tel: 3103734556)

πŸ“
Updated Business Mailing Address February 07, 2018

Registered at 4025 W 226TH ST, TORRANCE, CA 905052340 (Tel: 3103734556)

πŸ‘€
Provider Name / Credentials Updated February 07, 2018

Recorded as KELLSIE DAVIS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2018

Counselor

βœ…
NPI Profile Active September 12, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 12, 2016

Registered at 10929 SOUTH ST, SUITE 208B, CERRITOS, CA 907035340 (Tel: 5629245526)

πŸ“
Business Mailing Address (Initial Record) September 12, 2016

Registered at 10929 SOUTH ST, SUITE 208B, CERRITOS, CA 907035340 (Tel: 5629245526)

πŸ‘€
Provider Name / Credentials (Initial Record) September 12, 2016

Recorded as KELLSIE DAVIS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 12, 2016

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration September 15, 2015

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1528437043
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2015
Last Update: May 31, 2024
Sole Proprietor: No

Mailing Address

401 S Tustin St Bldg D

Orange, CA 928662550

Phone: 7142893936

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.