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Ezery Kennedy JR.
Mental Health Counselor in San Luis Obispo, California
NPI 1821353780

Ezery Kennedy JR. is a Mental Health Counselor based in San Luis Obispo, CA and is specialized in Mental Health. Ezery Kennedy JR. practices in San Luis Obispo, CA. The NPI Number for Ezery Kennedy JR. is 1821353780 and holds a License No. (California).

The current practice location address for Ezery Kennedy JR. is 277 South St Ste Y, San Luis Obispo, CA and can be reached out via phone at 805-541-5144 and via fax at 805-541-9480.

Location: 277 South St Ste Y, San Luis Obispo, CA, 93406-5408
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821353780
Provider Name
Ezery Kennedy JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
277 South St Ste Y, San Luis Obispo, CA, 93406-5408
Phone Number
805-541-5144
Fax Number
805-541-9480
Provider Enumeration Date
07/06/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
277 South St Ste Y
City
San Luis Obispo
State
California
Zip
93401-5039
Phone Number
805-541-5144
Fax Number
805-541-9480
person
Provider Business Mailing Address Details
Address
277 South St Ste Y
City
San Luis Obispo
State
California
Zip
93401-5039
Phone Number
805-541-5144
Fax Number
805-541-9480
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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