Ferreira, Kelly
Ferreira, Kelly is an sole proprietor health care provider with primary practice located at 715 Port St Apt 2 , Crockett CA 94525-1120. He recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as his primary health care specialty. Ferreira, Kelly can be contacted via phone (510) 860-6324.Contact Information
Primary practice address
715 Port St Apt 2
Crockett CA 94525-1120
Phone: (510) 860-6324
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Substance Abuse Rehabilitation Facility | 324500000X | C2080275 | California |
Profile Details
| NPI number | 1629445085 |
|---|---|
| LBN Legal business name | Ferreira, Kelly |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 1st, 2015 |
| Last updated | Sep 1st, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629445085 | NPPES |
| California | MEDICAID | C2080275 |
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