DR. KELSEY ANNE HOLIDAY PHD
NPI 1639882970
Psychologist - Clinical in San Diego, CA

Q: What is Kelsey Holiday's NPI number?

The NPI number for Kelsey Holiday is 1639882970. It was assigned to this individual provider in the NPPES registry on January 2, 2023.

Q: What is Kelsey Holiday's specialty?

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

Q: Is Kelsey Holiday enrolled in Medicare?

No. Kelsey Holiday has opted out of Medicare through July 24, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Kelsey Holiday was last updated on July 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 January 02, 2023Opted out of Medicare · through Jul 24, 2027

11120 E OCEAN AIR DR STE 101-114, SAN DIEGO, CA 92130(619) 736-8901 Get Directions Write a Review

NPPES record last updated: July 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Kelsey Anne Holiday Phd NPPES

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

DR. KELSEY ANNE HOLIDAY PHD (NPI 1639882970) is an individual clinical provider in San Diego, California, licensed in California (PSY33681) and active in the NPI registry since January 2023. She has opted out of Medicare through July 24, 2027 and maintains a secondary practice location in Los Angeles.

NPPES Registry Identity

NPI1639882970

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. KELSEY ANNE HOLIDAYCredential: PHD

Location Address11120 E OCEAN AIR DR STE 101-114San Diego, CA 92130-4683

Mailing Address11120 E Ocean Air Dr Ste 101-114San Diego, CA 92130-4683 · (619) 736-8901

Phone(619) 736-8901

Sole ProprietorYes

Enumeration DateJanuary 2, 2023

Last NPPES UpdateJuly 17, 2025

NPPES CertifiedJuly 17, 2025

✔ NPI 1639882970 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 · PSY33681

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.

11120 E OCEAN AIR DR STE 101-114, San Diego, CA 92130

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Secondary Practice Location 1

Location 12001 S Barrington Ave Ste 204Los Angeles, CA 90025-5385 · Phone (619) 736-8901

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. Kelsey Anne Holiday 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 July 24, 2023 through July 24, 2027.

Opt-Out Effective DateJuly 24, 2023

Opt-Out In Effect ThroughJuly 24, 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 Kelsey Holiday's NPI number?

The NPI number for Kelsey Holiday is 1639882970. It was assigned to this individual provider in the NPPES registry on January 2, 2023.

Where is Kelsey Holiday located?

Kelsey Holiday practices at 11120 E Ocean Air Dr Ste 101-114, San Diego, CA 92130. The listed phone number is (619) 736-8901.

What is Kelsey Holiday's specialty?

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

Is Kelsey Holiday enrolled in Medicare?

No. Kelsey Holiday has opted out of Medicare through July 24, 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 Kelsey Holiday was last updated on July 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.