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KENDRA WILLIBY PSYD
NPI 1306654090
Psychologist - Clinical in Sherman Oaks, CA

Active since December 26, 2024PECOS Enrolled
15030 VENTURA BLVD STE 11-282, SHERMAN OAKS, CA 91403(206) 802-8424 Get Directions Write a Review

NPPES record last updated: July 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 9, 2025, Dec 26, 2024 (2 updates tracked since 2024).

About Kendra Williby Psyd NPPES

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

KENDRA WILLIBY PSYD (NPI 1306654090) is an individual clinical provider in Sherman Oaks, California, licensed in California (PSY35470) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1306654090
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameKENDRA WILLIBYCredential: PSYD
Location Address15030 VENTURA BLVD STE 11-282Sherman Oaks, CA 91403-5470
Mailing Address15030 Ventura Blvd Ste 11-282Sherman Oaks, CA 91403-5470 · (206) 802-8424
Phone(206) 802-8424
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateDecember 26, 2024
Last NPPES UpdateJuly 9, 20252 updates tracked since enumeration
NPPES CertifiedJuly 9, 2025
✔ NPI 1306654090 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 · PSY35470
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.
15030 VENTURA BLVD STE 11-282, Sherman Oaks, CA 91403
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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 (PECOS)

Kendra Williby Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2466924196
PECOS Enrollment IDI20260615000549
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 Reassignment

Medicare enrollment records show Kendra Williby reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sud Specialty Group - Ca
298 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91403 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
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kendra Williby's NPI number?

The NPI number for Kendra Williby is 1306654090. It was assigned to this individual provider in the NPPES registry on December 26, 2024.

Where is Kendra Williby located?

Kendra Williby practices at 15030 Ventura Blvd Ste 11-282, Sherman Oaks, CA 91403. The listed phone number is (206) 802-8424.

What is Kendra Williby's specialty?

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

Is Kendra Williby enrolled in Medicare?

Yes. Kendra Williby is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kendra Williby's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kendra Williby reassigns Medicare benefits to Sud Specialty Group - Ca (Santa Clara, CA). The 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 Kendra Williby'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 Kendra Williby was last updated on July 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.