Black, Kelly

Black, Kelly is an individual health care provider with primary practice located at 32205 Snyder Ln , Homeland CA 92548-9600. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Black, Kelly can be contacted via phone (951) 623-7194.

Contact Information

Primary practice address
32205 Snyder Ln Homeland CA 92548-9600
Phone: (951) 623-7194
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 56220 California
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95024873 California

Profile Details

NPI number 1912653536
LBN Legal business name Black, Kelly
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2022
Last updated Apr 18th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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