Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colleen Kelly

Individual provider Nurse Practitioner · NPI 1578932190

Colleen Kelly is a Nurse Practitioner in San Diego, California. Qualified in 2014, 12 years ago. Practices with Rady Children's Hospital San Diego, a 161-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
12
Licensed in
CA
In the registry since
2015
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Practice location Address checks out

3030 Childrens Way
San Diego, CA 92123-4232
Phone: (858) 966-8974
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95002304 (CA)

Record details

NPI number1578932190
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 24, 2015
Last updated in NPPESNovember 18, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Rady Children'S Hospital San Diego — 161 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in San Diego