Kelly, Jake

Kelly, Jake is an individual health care provider with primary practice located at 701 Scofield Ave , Wasco CA 93280-7515. He recently has only one registered license in Behavioral Health & Social Service Providers / Forensic, which is considered as his primary health care specialty. Kelly, Jake can be contacted via phone (661) 758-8400.

Contact Information

Primary practice address
701 Scofield Ave Wasco CA 93280-7515
Phone: (661) 758-8400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Forensic 103TF0200X

Profile Details

NPI number 1386094993
LBN Legal business name Kelly, Jake
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2016
Last updated Jun 14th, 2016 - about 8 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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