Individual
DR. JEFF KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1080 MASON MALL STE 6C, CRESCENT CITY, CA 95531-4335
(707) 951-7620
Mailing address
5905 LAKE EARL DR, CRESCENT CITY, CA 95532-0001
(707) 465-1000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY20204
CA
Other
Enumeration date
06/02/2008
Last updated
02/07/2020
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