Individual
MR. SHAYNE THOMAS KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
187 E WILBUR RD STE 14, THOUSAND OAKS, CA 91360-7938
(818) 253-4150
Mailing address
187 E WILBUR RD STE 14, THOUSAND OAKS, CA 91360-7938
(818) 253-4150
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/05/2016
Last updated
04/25/2024
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