Individual
CHALISS KIRKENDOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
160 GLEN COVE MARINA RD E STE 102, VALLEJO, CA 94591-7290
(707) 648-2000
Mailing address
160 GLEN COVE MARINA RD E STE 102, VALLEJO, CA 94591-7290
(707) 648-2000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
08/27/2025
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