KELLY VINCENT
NPI 1053728865
Psychologist - Clinical in Encinitas, CA

Q: What is Kelly Vincent's NPI number?

The NPI number for Kelly Vincent is 1053728865. It was assigned to this individual provider in the NPPES registry on July 14, 2014.

Q: What is Kelly Vincent's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Kelly Vincent enrolled in Medicare?

No. Kelly Vincent has opted out of Medicare through September 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Kelly Vincent was last updated on July 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 14, 2014Opted out of Medicare · through Sep 10, 2027

169 SAXONY RD STE 111, ENCINITAS, CA 92024(760) 278-8934 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Kelly Vincent NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY VINCENT (NPI 1053728865) is an individual clinical provider in Encinitas, California, licensed in California (30672) and active in the NPI registry since July 2014. She has opted out of Medicare through September 10, 2027.

NPPES Registry Identity

NPI1053728865

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameKELLY VINCENT

Location Address169 SAXONY RD STE 111Encinitas, CA 92024-6779

Mailing Address169 Saxony Rd Ste 111Encinitas, CA 92024-6779 · (916) 601-1925

Phone(760) 278-8934

Sole ProprietorNo

Enumeration DateJuly 14, 2014

Last NPPES UpdateJuly 28, 2025

NPPES CertifiedJuly 28, 2025

✔ NPI 1053728865 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in CA · 30672

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

169 SAXONY RD STE 111, Encinitas, CA 92024

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kelly Vincent has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 10, 2025 through September 10, 2027.

Opt-Out Effective DateSeptember 10, 2025

Opt-Out In Effect ThroughSeptember 10, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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