KELSEY ANN HIPPEN
NPI 1104191832
Psychologist in San Rafael, CA

Active since March 13, 2012PECOS Enrolled
3270 KERNER BLVD, SAN RAFAEL, CA 94901(415) 473-6874 Get Directions Write a Review

NPPES record last updated: August 10, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 10, 2023, May 21, 2021 (2 updates tracked since 2021).

About Kelsey Ann Hippen NPPES

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

KELSEY ANN HIPPEN (NPI 1104191832) is an individual psychologist in San Rafael, California, licensed in California (34211) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104191832
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameKELSEY ANN HIPPEN
Location Address3270 KERNER BLVDSan Rafael, CA 94901-4840
Mailing Address3270 Kerner BlvdSan Rafael, CA 94901-4840
Sole ProprietorYes
Enumeration DateMarch 13, 2012
Last NPPES UpdateAugust 10, 20232 updates tracked since enumeration
NPPES CertifiedAugust 10, 2023
✔ NPI 1104191832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · 34211
Definition
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.
3270 KERNER BLVD, San Rafael, CA 94901

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelsey Ann Hippen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Kelsey Hippen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Federally Qualified Health Center (FQHC)
330 ELLIS ST
San Francisco, CA 94102
  • Reassigned Medicare billing, California enrollment
  • 76 clinicians in this Medicare group
Psychiatric Hospital
2100 NAPA VALLEJO HWY
Napa, CA 94558
  • Reassigned Medicare billing, California enrollment
  • 755 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

Social Worker
3270 KERNER BLVD, SUITE A
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Nurse Practitioner (Psychiatric/Mental Health)
3270 KERNER BLVD, SUITE B
SAN RAFAEL, CA 94901
Student in an Organized Health Care Education/Training Program
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Psychiatry & Neurology (Psychiatry)
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Case Manager/Care Coordinator
3270 KERNER BLVD
SAN RAFAEL, CA 94901
Counselor (Mental Health)
3270 KERNER BLVD, SUITE B
SAN RAFAEL, CA 94901
Counselor (Mental Health)
3270 KERNER BLVD, BUILDING A SUITE C
SAN RAFAEL, CA 94901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsey Hippen's NPI number?

The NPI number for Kelsey Hippen is 1104191832. It was assigned to this individual provider in the NPPES registry on March 13, 2012.

Where is Kelsey Hippen located?

Kelsey Hippen practices at 3270 Kerner Blvd, San Rafael, CA 94901. The listed phone number is (415) 473-6874.

What is Kelsey Hippen's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kelsey Hippen enrolled in Medicare?

Yes. Kelsey Hippen is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kelsey Hippen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelsey Hippen reassigns Medicare benefits to 2 organizations: Healthright 360 (San Francisco, CA) and Department Of State Hospitals (Napa, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelsey Hippen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelsey Hippen was last updated on August 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.