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Jennifer Kelly
Mental Health Counselor in Santa Cruz, California
NPI 1578814901

Jennifer Kelly is a Mental Health Counselor based in Santa Cruz, CA and is specialized in Mental Health. Jennifer Kelly practices in Santa Cruz, CA. The NPI Number for Jennifer Kelly is 1578814901 and holds a License No. (California).

The current practice location address for Jennifer Kelly is 1080 Emeline Ave, Santa Cruz, CA and can be reached out via phone at 831-454-4170.

Location: 1080 Emeline Ave, Santa Cruz, CA, 95060-1966
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578814901
Provider Name
Jennifer Kelly
Credential
Provider Entity Type
Individual
Gender
Female
Address
1080 Emeline Ave, Santa Cruz, CA, 95060-1966
Phone Number
831-454-4170
Fax Number
Provider Enumeration Date
09/25/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZZZ91892Z 01 CA SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
ZZZ92069Z 01 CA SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
institution
Provider Business Practice Location Address Details
Address
1080 Emeline Ave
City
Santa Cruz
State
California
Zip
95060-1966
Phone Number
831-454-4170
Fax Number
person
Provider Business Mailing Address Details
Address
1080 Emeline Ave
City
Santa Cruz
State
California
Zip
95060-1966
Phone Number
831-454-4170
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
(California)
Definition
Definition to come...
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