Individual
DR. DIANE RENEE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1021 N SEPULVEDA BLVD, SUITE H, MANHATTAN BEACH, CA 90266-5965
(310) 559-3164
(310) 802-8856
Mailing address
1021 N SEPULVEDA BLVD, SUITE H, MANHATTAN BEACH, CA 90266-5965
(310) 559-3164
(310) 802-8856
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY12962
CA
106H00000X
Marriage & Family Therapist
MFC5783
CA
Other
Enumeration date
10/03/2006
Last updated
03/02/2016
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