Kallis, Jonathan A
Kallis, Jonathan A is an individual health care provider with primary practice located at 39000 Bob Hope Dr , Rancho Mirage CA 92270-3221. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Kallis, Jonathan A can be contacted via phone (760) 837-8767.Contact Information
Primary practice address
39000 Bob Hope Dr
Rancho Mirage CA 92270-3221
Phone: (760) 837-8767
Fax: (760) 837-8806
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | I0009706 | Ohio |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 82079 | California |
Profile Details
| NPI number | 1629017868 |
|---|---|
| LBN Legal business name | Kallis, Jonathan A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Jun 30th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629017868 | NPPES |
| Kentucky | MEDICAID | 8200117300 |
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