KENRICK BRIAN LICORISH MD
NPI 1144759085
Psychiatry & Neurology - Psychiatry in Santa Clara, CA

Q: What is Kenrick Licorish's NPI number?

The NPI number for Kenrick Licorish is 1144759085. It was assigned to this individual provider in the NPPES registry on June 5, 2017.

Q: What is Kenrick Licorish's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Kenrick Licorish was last updated on June 14, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 June 05, 2017PECOS EnrolledAccepts Medicare Assignment

5201 GREAT AMERICA PKWY STE 320, SANTA CLARA, CA 95054(408) 384-3758 Get Directions Write a Review

NPPES record last updated: June 14, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 14, 2025, Jun 5, 2017 (2 updates tracked since 2017).

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About Kenrick Brian Licorish Md NPPES

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

KENRICK BRIAN LICORISH MD (NPI 1144759085) is an individual psychiatry provider in Santa Clara, California, licensed in California (A159723) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1144759085

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameKENRICK BRIAN LICORISHCredential: MD

Location Address5201 GREAT AMERICA PKWY STE 320Santa Clara, CA 95054-1140

Mailing Address2351 Clay St Ste 380San Francisco, CA 94115-1931

Phone(408) 384-3758

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateJune 5, 2017

Last NPPES UpdateJune 14, 20252 updates tracked since enumeration

NPPES CertifiedJune 14, 2025

✔ NPI 1144759085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in CA · A159723

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

5201 GREAT AMERICA PKWY STE 320, Santa Clara, CA 95054

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kenrick Brian Licorish Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133457765

PECOS Enrollment IDI20190821000760

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

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

Kenrick Licorish Medical Corporation

Same address

Psychiatry

5201 GREAT AMERICA PKWY STE 320
Santa Clara, CA 95054

Reassigned Medicare billing, California enrollment

NPI 1518662485 (408) 384-3758

Bay Psychiatric Associates

36 mi

Psychiatry

2020 MILVIA ST STE 440
Berkeley, CA 94704

Reassigned Medicare billing, California enrollment
116 clinicians in this Medicare group

NPI 1427163229 (510) 204-4635

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

204 services21 patients

Psychotherapy with evaluation and management visit, 30 minutes 90833

Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.

164 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95054 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$206.04 typical visit price

range $70.37 – $206.04

Typical copayment $51.51 (range $17.59 – $51.51)

Most-billed visit code 99205

Established Patient

$86.56 typical visit price

range $23.96 – $169.60

Typical copayment $21.64 (range $5.99 – $42.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MRS. DEBORAH MARIE BOUCHER-CARTER

Marriage & Family Therapist