Kelley, Haruka
Kelley, Haruka is an individual health care provider with primary practice located at 2500 Milvia St , Berkeley CA 94704. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Kelley, Haruka can be contacted via phone (510) 204-5600.Contact Information
Primary practice address
2500 Milvia St
Berkeley CA 94704
Phone: (510) 204-5600
Fax: (510) 506-7722
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 95007416 | California |
Profile Details
| NPI number | 1770822116 |
|---|---|
| LBN Legal business name | Kelley, Haruka |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 5th, 2013 |
| Last updated | Apr 29th, 2019 - about 5 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 | 1770822116 | NPPES |
| California | Other | NP95007416 | STATE MEDICAL LICENSE |
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