Perry, Kitti Jean

Perry, Kitti Jean is an individual health care provider with primary practice located at 3000 Cleveland Ave Suite 105, Santa Rosa CA 95403-2171. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Perry, Kitti Jean can be contacted via phone (707) 527-0610.

Contact Information

Primary practice address
3000 Cleveland Ave Suite 105 Santa Rosa CA 95403-2171
Phone: (707) 527-0610
Fax: (707) 875-8873
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCS4322 California

Profile Details

NPI number 1710964630
LBN Legal business name Perry, Kitti Jean
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2005
Last updated Jul 9th, 2007 - about 17 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 1710964630 NPPES
California Other #287461 MANAGED HEALTH NETWORK
California MEDICAID CSW043220 MANAGED HEALTH NETWORK
California Other LCS043220 MANAGED HEALTH NETWORK

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