MEDICARE: DR. JENNIFER ANN REGO KEARNEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	G57306	CA
2	2084P0800X	Psychiatry Physician	G57306	CA

General Provider Information

NPI Number	:	1548355878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER ANN REGO KEARNEY MD

Provider Business Mailing Address
First Line	:	3835 N FREEWAY BLVD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1954
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8950 VILLA LA JOLLA DR STE C217
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1712
Country	:	US
Telephone Number	:	858-869-8699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	06/23/2026

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