Kelly, Kevin Thomas

Kelly, Kevin Thomas is an sole proprietor health care provider with primary practice located at 598 Cochrane Ave , Ukiah CA 95482-5621. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Kelly, Kevin Thomas can be contacted via phone (707) 463-1447.

Contact Information

Primary practice address
598 Cochrane Ave Ukiah CA 95482-5621
Phone: (707) 463-1447
Fax: (866) 204-9690
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY9275 California

Profile Details

NPI number 1508059080
LBN Legal business name Kelly, Kevin Thomas
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 20th, 2007
Last updated Aug 20th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1508059080 NPPES
California Other A00PL92750 BLUE SHIELD UIC #
California Other 7809105 BLUE SHIELD UIC #
California Other PA0092759 BLUE SHIELD UIC #
California Other #00PL92750 BLUE SHIELD UIC #
California Other PSY00009275 BLUE SHIELD UIC #

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