DR. KELLY BLUE (NPI# 1386849339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386849339 |
| Entity Type | Individual |
| Full Name | DR. KELLY BLUE |
| Credential | M.D. |
| Practice Address |
312 Brookside Ave Redlands CA 92373-4608 |
| Practice Telephone | 9093079663 |
| Mailing Telephone | 9093079663 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
G084831 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
312 BROOKSIDE AVE |
| City | REDLANDS |
| State | CA |
| Zip Code | 92373-4608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295365955 | Michelle Buckman | Nurse Practitioner | 312 Brookside Ave, Redlands, CA 92373-4608 | 2020-01-22 |
| 1467915959 | Rojean Lorraine Talmadge | Marriage & Family Therapist | 312 Brookside Ave, Redlands, CA 92373-4608 | 2019-04-11 |
| 1952703282 | Optimal Movement Physical Therapy LLC | Clinic/Center | 312 Brookside Ave, Redlands, CA 92373-4608 | 2014-09-18 |
| 1891927547 | Laura J. Hodge | Psychologist | 312 Brookside Ave, Redlands, CA 92373-4608 | 2009-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473422 | Mindfulness Counseling Services | Marriage & Family Therapist | 101 E. Redlands, Suite 170a, Redlands, CA 92373 | 2020-09-24 |
| 1710596721 | Vandna Mittal | Counselor | 26967 Beamount Avenue, 1020 Coronado Drive, Redlands, CA 92373 | 2020-07-26 |
| 1164062345 | Sara Bencoe | Nurse Practitioner | 101 E. Redlands Blvd. Ste. 106, Redlands, CA 92373 | 2020-01-15 |
| 1033604103 | John Duane Wuchenich | Anesthesiology | 451 Summit Avenue, Redlands, CA 92373 | 2018-06-29 |
| 1013401074 | Adept Hospice Care | Hospice Care, Community Based | 515 New Jersey St., Suite G, Redlands, CA 92373 | 2018-06-21 |
| 1134616121 | Rodrigo Robles | Student in an Organized Health Care Education/Training Program | 26001 Redlands Blvd ., 2nd Floor, 2d 301, Redlands, CA 92373 | 2018-04-16 |
| 1760987614 | Redlands Endodontics | Dentist | 245 Terracina Blvd Suite 207 B, Redlands, CA 92373 | 2018-03-23 |
| 1487164166 | Tyler Stafford | Behavioral Analyst | 1467 Ford St. Suite 104, Redlands, CA 92373 | 2017-10-06 |
| 1083131486 | Shannon Palmowski | Behavioral Analyst | Institute for Behavioral Health, 1041 Alabama Ave, Redlands, CA 92373 | 2017-08-25 |
| 1275062622 | Erim Sarbuland | Marriage & Family Therapist | 101 East Redlands Boulevard, Suites #215, Redlands, CA 92373 | 2017-06-08 |
| Find all providers in zip 92373 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053602151 | Cheryl Lea Green | Psychiatry & Neurology | Behavioral Medicine Center, Loma Linda University, 1710 Barton Rd, Redlands, CA 92373-5304 | 2011-04-22 |
| 1730294356 | Jamie L. Snyder | Psychiatry & Neurology | 1686 Barton Rd Ste D, Redlands, CA 92373-1489 | 2006-08-21 |
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| 1225527427 | Better Life Therapy, Inc. | Psychiatry & Neurology | 9520 Escondido Canyon Rd, Santa Clarita, CA 91390-4811 | 2018-05-03 |
| 1821515099 | J. Kirk Hartman, M.d. | Psychiatry & Neurology | 3860 Blackhawk Rd # 120, Danville, CA 94506-4905 | 2017-08-28 |
| 1912432055 | Centered Health LLC | Psychiatry & Neurology | 6422 W 6th St, Los Angeles, CA 90048-4714 | 2017-04-26 |
| 1255871182 | Carol R Harrus | Psychiatry & Neurology | 517 Patricia Ln, Palo Alto, CA 94303-2856 | 2017-02-25 |
| 1437539509 | Ehab Yacoub, Md Inc. | Psychiatry & Neurology | 1225 W 190th St Ste 470, Gardena, CA 90248-4316 | 2015-06-04 |
| Find all providers with the same taxonomy | ||||
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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.