Individual
DR. KATIE JO KERIDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
825 COLLEGE AVE STE 4, SANTA ROSA, CA 95404-4108
(510) 428-3000
Mailing address
1716 HURLBUT AVE, SEBASTOPOL, CA 95472-2881
(707) 835-4252
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY29632
CA
Other
Enumeration date
06/24/2010
Last updated
09/26/2018
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