Individual
KEVIN ERIC KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
368 FELL ST, SAN FRANCISCO, CA 94102-5144
(415) 861-0828
(415) 861-0257
Mailing address
368 FELL ST, SAN FRANCISCO, CA 94102-5144
(415) 861-0828
(415) 861-0257
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
3269
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
19354
CA
Other
Enumeration date
10/05/2009
Last updated
11/29/2016
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