Kelly, Diane G
Kelly, Diane G is an sole proprietor health care provider with primary practice located at 260 Newport Center Dr Ste 203, Newport Beach CA 92660-7520. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kelly, Diane G can be contacted via phone (949) 244-6140.Contact Information
Primary practice address
260 Newport Center Dr Ste 203
Newport Beach CA 92660-7520
Phone: (949) 244-6140
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCS11005 | California |
Profile Details
| NPI number | 1942417035 |
|---|---|
| LBN Legal business name | Kelly, Diane G |
| Credentials | LCSW MSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2007 |
| Last updated | Aug 6th, 2012 - about 14 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 | 1942417035 | NPPES |
| California | Other | LCS11005 | LCSW |
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