KELLY H WERNER PHD
NPI 1568072973
Psychologist in Sausalito, CA

Active since August 01, 2020Opted out of Medicare · through Aug 17, 2028
108 CAZNEAU AVE, SAUSALITO, CA 94965(510) 847-5127 Get Directions Write a Review

NPPES record last updated: August 1, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelly H Werner Phd NPPES

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

KELLY H WERNER PHD (NPI 1568072973) is an individual psychologist in Sausalito, California, licensed in California (PSY21858) and active in the NPI registry since August 2020. She has opted out of Medicare through August 17, 2028.

NPPES Registry Identity

NPI1568072973
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameKELLY H WERNERCredential: PHD
Location Address108 CAZNEAU AVESausalito, CA 94965-1817
Mailing Address108 Cazneau AveSausalito, CA 94965-1817 · (510) 847-5127
Sole ProprietorYes
Enumeration DateAugust 1, 2020
NPPES CertifiedAugust 1, 2020
✔ NPI 1568072973 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 · PSY21858
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.
108 CAZNEAU AVE, Sausalito, CA 94965

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 H Werner 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 17, 2024 through August 17, 2028.

Opt-Out Effective DateAugust 17, 2024
Opt-Out In Effect ThroughAugust 17, 2028Opt-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 Kelly Werner's NPI number?

The NPI number for Kelly Werner is 1568072973. It was assigned to this individual provider in the NPPES registry on August 1, 2020.

Where is Kelly Werner located?

Kelly Werner practices at 108 Cazneau Ave, Sausalito, CA 94965. The listed phone number is (510) 847-5127.

What is Kelly Werner's specialty?

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

Is Kelly Werner enrolled in Medicare?

No. Kelly Werner has opted out of Medicare through August 17, 2028. 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 Kelly Werner was last updated on August 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.