Individual
SAMUEL DAVID KELLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1210 E BELLEVUE AVE, SANTA ROSA, CA 95407-2764
(707) 542-3671
Mailing address
180 GOLF COURSE DR APT 150, ROHNERT PARK, CA 94928-4914
(530) 526-4113
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
230146968
CA
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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