Kelly, Carol Ann
Kelly, Carol Ann is an sole proprietor health care provider with primary practice located at 10451 Tennessee Ave , Los Angeles CA 90064-2329. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Kelly, Carol Ann can be contacted via phone (310) 475-7434.Contact Information
Primary practice address
10451 Tennessee Ave
Los Angeles CA 90064-2329
Phone: (310) 475-7434
Fax: (310) 475-7844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PSY 5359 | California |
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | PSY 5359 | California |
Profile Details
| NPI number | 1528249091 |
|---|---|
| LBN Legal business name | Kelly, Carol Ann |
| Credentials | ED.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 26th, 2007 |
| Last updated | Nov 26th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528249091 | NPPES |
| California | Other | OOPL53590 | MEDICAL |
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