Individual
JEFFREY GLEN KELLY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3440 VIKING DR, SACRAMENTO, CA 95827-2844
(916) 262-8598
Mailing address
3440 VIKING DR, SACRAMENTO, CA 95827-2844
(916) 262-8598
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/19/2018
Last updated
06/05/2025
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