Heather Lake Kelly in Scotts Valley - Clinical
Heather Lake Kelly - NPI 1801931548
Heather Lake Kelly is a Clinical in Scotts Valley, California. Heather Lake Kelly practices all healthcare services and medical treatments related to Clinical. The NPI Number for Heather Lake Kelly is 1801931548. The last update date is 2007-07-08.
Heather Lake Kelly's current location address is 800 Bethany Dr, Scotts Valley, California. You can contact this provider via phone number 8314383800. The mailing address for Heather Lake Kelly is 800 Bethany Dr, Scotts Valley, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Heather Lake Kelly |
|---|---|
| Address | 800 Bethany Dr, Scotts Valley, California |
| Phone Number | 8314383800 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1801931548 |
|---|---|
| Provider Enumeration Date | 2007-02-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 800 Bethany Dr |
|---|---|
| City | Scotts Valley |
| State | California (CA) |
| Post Code | 950662820 |
| Phone Number | 8314383800 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY 18917 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique provider identifier assigned to Heather Lake Kelly?
The Heather Lake Kelly has been issued the NPI (National Provider Identifier) 1801931548 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete physical address where Heather Lake Kelly is located?
The Heather Lake Kelly is situated at the following address: 800 Bethany Dr, Scotts Valley, CA, 950662820.
What is the Heather Lake Kelly's area of specialization and corresponding taxonomy classification?
The Heather Lake Kelly's specialty field is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their specialties.
On what date did Heather Lake Kelly receive its 1801931548 assignment from the Centers for Medicare & Medicaid Services?
The Heather Lake Kelly was assigned its 1801931548 on 2007-02-20, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Heather Lake Kelly most recently updated or revised?
The details related to Heather Lake Kelly, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.
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