person
Kelly Miner-gann
Mental Health Counselor in Grass Valley, California
NPI 1891029005

Kelly Miner-gann is a Mental Health Counselor based in Grass Valley, CA and is specialized in Mental Health. Kelly Miner-gann practices in Grass Valley, CA. The NPI Number for Kelly Miner-gann is 1891029005 and holds a License No. (California).

The current practice location address for Kelly Miner-gann is 844 Old Tunnel Rd, Grass Valley, CA and can be reached out via phone at 530-273-4984 and via fax at 530-273-4573.

Location: 844 Old Tunnel Rd, Grass Valley, CA, 95945-8524
person
Provider Profile Details
NPI Number
1891029005
Provider Name
Kelly Miner-gann
Credential
Provider Entity Type
Individual
Gender
Female
Address
844 Old Tunnel Rd, Grass Valley, CA, 95945-8524
Phone Number
530-273-4984
Fax Number
530-273-4573
Provider Enumeration Date
09/22/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
FHC 70042F 01 CA SANTA CRUZ COUNTY MEDI-CAL PROVIDER #
FHC 70044F 01 CA SANTA CRUZ COUNTY MEDI-CAL PROVIDER #
ZZZ91891Z 01 CA SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
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
844 Old Tunnel Rd
City
State
Zip
95945-8524
Phone Number
530-273-4984
Fax Number
530-273-4573
person
Provider Business Mailing Address Details
Address
844 Old Tunnel Rd
City
State
Zip
95945-8524
Phone Number
530-273-4984
Fax Number
530-273-4573
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
(California)
Definition
Definition to come...
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