Dr Kelly Leigh Edyburn, PHD in Oakland, CA - Medicare Psychologist Provider

Dr Kelly Leigh Edyburn, PHD is a medicare enrolled "Psychologist - Clinical Child & Adolescent" provider in Oakland, California. Her current practice location is 8711 Macarthur Blvd, Oakland, California. You can reach out to her office (for appointments etc.) via phone at (510) 428-3556.

Dr Kelly Leigh Edyburn is licensed to practice in California (license number PSY33603) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1801560180.

Contact Information

	Dr Kelly Leigh Edyburn, PHD
	8711 Macarthur Blvd, Oakland, CA 94605-4000
	(510) 428-3556
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kelly Leigh Edyburn
Gender	Female
Speciality	Psychologist - Clinical Child & Adolescent
Location	8711 Macarthur Blvd, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1801560180
Provider Enumeration Date: 08/02/2021
Last Update Date: 05/11/2023

Medicare PECOS Information:

PECOS PAC ID: 4880040039
Enrollment ID: I20231025001168

Medical Identifiers

Medical identifiers for Dr Kelly Leigh Edyburn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1801560180	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC2200X	Psychologist - Clinical Child & Adolescent	PSY33603 (California)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kelly Leigh Edyburn allows following entities to bill medicare on her behalf.

Entity Name	University Of California San Francisco
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861578973 PECOS PAC ID: 4486567229 Enrollment ID: O20031212000897

Entity Name	Ucsf Medical Group Business Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477624104 PECOS PAC ID: 3779497870 Enrollment ID: O20040622001513

Entity Name	Ucsf Psychiatry
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427105279 PECOS PAC ID: 4981680832 Enrollment ID: O20040629001513

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelly Leigh Edyburn is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kelly Leigh Edyburn, PHD 8711 Macarthur Blvd, Oakland, CA 94605-4000 Ph: (510) 428-3556	Dr Kelly Leigh Edyburn, PHD 8711 Macarthur Blvd, Oakland, CA 94605-4000 Ph: (510) 428-3556

Reviews and Comments

Psychologist in Oakland, CA

Dr. Ronald C. Kimmons, PSYD, MSW, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 2303 25th Ave, Oakland, CA 94601 Phone: 510-219-6405
Dr. Morgan E Bartholomew, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 970 Aileen St, Oakland, CA 94608 Phone: 661-992-6871
Dr. Dina Divsalar, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 711 Calmar Ave, Oakland, CA 94610 Phone: 510-206-3973
Dr. Cheryl Jacques, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 5665 College Ave Ste 320c, Oakland, CA 94618 Phone: 510-653-0678 Fax: 510-898-9889
Anna Wong, PSY Psychologist Medicare: Not Enrolled in Medicare Practice Location: 275 W Macarthur, Oakland, CA 94611 Phone: 510-752-1000 Fax: 510-752-1404
Debbie Rieza, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 400 29th St Ste 105, Oakland, CA 94609 Phone: 510-268-8120
Nadrienne A Pinnock, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 3301 E 12th St, Oakland, CA 94601 Phone: 510-269-9030

Dr Kelly Leigh Edyburn, PHD - Medicare Psychologist in Oakland, CA