Keridan, Katie Jo

Keridan, Katie Jo is an sole proprietor health care provider with primary practice located at 825 College Ave Ste 4 , Santa Rosa CA 95404-4108. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Keridan, Katie Jo can be contacted via phone (510) 428-3000.

Contact Information

Primary practice address
825 College Ave Ste 4 Santa Rosa CA 95404-4108
Phone: (510) 428-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PSY29632 California

Profile Details

NPI number 1225349145
LBN Legal business name Keridan, Katie Jo
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 24th, 2010
Last updated Sep 26th, 2018 - about 8 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.

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