Individual
HARUKA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 MILVIA ST, BERKELEY, CA 94704
(510) 204-5600
(510) 506-7722
Mailing address
2350 W EL CAMINO REAL FL 2, MOUNTAIN VIEW, CA 94040-6203
(510) 204-5600
(510) 506-7722
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
95007416
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP95007416
STATE MEDICAL LICENSE
CA
Enumeration date
02/05/2013
Last updated
04/29/2019
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