Organization
HEALTH & SOCIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAY KELSO M. H. CLINICIAN (SUPERVISOR)
(707) 784-2140
Entity
Organization
Contact information
Practice address
2101 COURAGE DR, FAIRFIELD, CA 94533-6717
(707) 784-2140
(707) 784-2164
Mailing address
1390 MATTHEW DR, FAIRFIELD, CA 94533-4161
(707) 436-2456
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/03/2007
Last updated
07/18/2008
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