Individual
KELLY MICHELLE WHITEFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3075 ADELINE ST STE 120, BERKELEY, CA 94703-2579
(510) 848-1112
Mailing address
3075 ADELINE ST STE 120, BERKELEY, CA 94703-2579
(510) 848-1112
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB94028429
CA
Other
Enumeration date
06/21/2018
Last updated
09/08/2024
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