Healthcare Provider Details

I. General information

NPI: 1063686111
Provider Name (Legal Business Name): KAREN ANITA ZELAYA-KENDALL PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2008
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 PROSPECT ST STE 200
LA JOLLA CA
92037-4261
US

IV. Provider business mailing address

1650 MARKET ST STE 3600
PHILADELPHIA PA
19103-7334
US

V. Phone/Fax

Practice location:
  • Phone: 484-557-2367
  • Fax: 484-840-5613
Mailing address:
  • Phone: 484-557-2367
  • Fax: 484-840-5613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPS016415
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS016415
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberPS016415
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY34533
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: