Individual
KELLIANN LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 S HARBOR BLVD, ANAHEIM, CA 92805-3700
(714) 871-5646
Mailing address
222 S HARBOR BLVD, ANAHEIM, CA 92805-3700
(714) 871-5646
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
CA
Other
Enumeration date
11/12/2018
Last updated
11/17/2025
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