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DR. COLLEEN MARIE KENNEDY PHD
NPI 1467025387
Psychologist - Clinical in Poway, CA

Active since July 19, 2021Opted out of Medicare · through Aug 21, 2027
14105 LOS NIETOS AVE, POWAY, CA 92064(858) 215-5131 Get Directions Write a Review

NPPES record last updated: May 18, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 18, 2023, Aug 12, 2022, Aug 7, 2022 and 1 more (4 updates tracked since 2021).

About Dr. Colleen Marie Kennedy Phd NPPES

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

DR. COLLEEN MARIE KENNEDY PHD (NPI 1467025387) is an individual clinical provider in Poway, California, licensed in California (PSY32722) and active in the NPI registry since July 2021. She has opted out of Medicare through August 21, 2027.

NPPES Registry Identity

NPI1467025387
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. COLLEEN MARIE KENNEDYCredential: PHD
Location Address14105 LOS NIETOS AVEPoway, CA 92064-3020
Mailing Address14105 Los Nietos AvePoway, CA 92064-3020 · (858) 215-5131
Phone(858) 215-5131
Sole ProprietorYes
Enumeration DateJuly 19, 2021
Last NPPES UpdateMay 18, 20234 updates tracked since enumeration
NPPES CertifiedMay 18, 2023
✔ NPI 1467025387 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 · PSY32722
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.
14105 LOS NIETOS AVE, Poway, CA 92064
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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

Dr. Colleen Marie Kennedy Phd 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 August 21, 2025 through August 21, 2027.

Opt-Out Effective DateAugust 21, 2025
Opt-Out In Effect ThroughAugust 21, 2027Opt-out affidavits renew automatically every two years unless cancelled

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 Colleen Kennedy's NPI number?

The NPI number for Colleen Kennedy is 1467025387. It was assigned to this individual provider in the NPPES registry on July 19, 2021.

Where is Colleen Kennedy located?

Colleen Kennedy practices at 14105 Los Nietos Ave, Poway, CA 92064. The listed phone number is (858) 215-5131.

What is Colleen Kennedy's specialty?

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

Is Colleen Kennedy enrolled in Medicare?

No. Colleen Kennedy has opted out of Medicare through August 21, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Colleen Kennedy was last updated on May 18, 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.