Individual
DEIRDRA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2230 STOCKTON BLVD, SACRAMENTO, CA 95817-1353
(916) 734-7523
Mailing address
2230 STOCKTON BLVD, SACRAMENTO, CA 95817-1353
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A199103
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2020
Last updated
01/12/2025
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