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:
Health care specialties
Specialty | Code | License # | 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 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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