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

Dr. Mallory Adele Kennedy, OD

Individual provider Optometrist · NPI 1538511837

Dr. Mallory Adele Kennedy, OD is an Optometry in Riverside, California. Qualified in 2016, 10 years ago. Practices with Riverside-San Bernardino County Indian Health Inc, a 45-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
10
Licensed in
CA
In the registry since
2016
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

7379 Indiana Ave
Riverside, CA 92504-4547
Phone: (951) 684-7822
Fax: (951) 977-8075
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 33508TLG (CA)

Record details

NPI number1538511837
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorYes
NPI enumeratedJuly 11, 2016
Last updated in NPPESAugust 6, 2021
Certification dateAugust 6, 2021
Mailing address7379 Indiana Ave, Riverside, CA 92504-4547

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Riverside-San Bernardino County Indian Health Inc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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