MS. DEBRA J KELLY (NPI# 1093078867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093078867 |
| Entity Type | Individual |
| Full Name | MS. DEBRA J KELLY |
| Credential | MFT |
| Practice Address |
114 Sotoyome St Santa Rosa CA 95405-4804 |
| Practice Telephone | 7075690459 |
| Practice Fax Number | 7075703941 |
| Mailing Telephone | 7075690459 |
| Mailing Fax Number | 7075703941 |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2012-06-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MFC19530 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275065237 | Debra Kelly | Occupational Therapist | 3619 Pembrook Dr, Sarasota, FL 34239-6708 | 2017-03-29 |
| 1023442886 | Debra A Kelly | Licensed Practical Nurse | 222 N Little Tor Rd, New City, NY 10956-2616 | 2013-08-29 |
| 1861617946 | Debra A Kelly | Occupational Therapist | 3219 Knollwood Cir, Geneva, IL 60134-4631 | 2007-04-16 |
| 1154898641 | Debra Eugenia Kelly | Peer Specialist | 2600 Sw Holden St, Seattle, WA 98126-3505 | 2018-11-01 |
| 1003278797 | Debra A. Kelly | Marriage & Family Therapist | 10065 Old Grove Rd Ste 200, San Diego, CA 92131-1664 | 2016-03-22 |
| 1346627403 | Debra Kelly | Speech-Language Pathologist | 202 W 3rd St, Louisville, NE 68037-7089 | 2015-04-28 |
| 1275978116 | Debra J. Kelly | Registered Nurse | 30 Elm Ave, Hyannis, MA 02601-5547 | 2013-05-06 |
| 1376746909 | Debra Kelly | Radiologic Technologist | 665 Winter St Se, Salem, OR 97301-3919 | 2007-06-10 |
| 1730258104 | Debra A. Kelly | Social Worker | 160 Medical Cir, West Columbia, SC 29169-3656 | 2006-11-07 |
| 1386678464 | Debra A Kelly | Nurse Anesthetist, Certified Registered | 6701 N Charles St, Towson, MD 21204-6808 | 2006-07-11 |
| Street Address |
114 SOTOYOME ST |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1730710260 | Harold Joseph Bahr | Counselor | 1550 N Dutton Ave, Santa Rosa, CA 95401-4601 | 2020-02-03 |
| 1801432398 | William Carroll | Counselor | 1260 N Dutton Ave Ste 185, Santa Rosa, CA 95401-7146 | 2019-11-20 |
| 1497390462 | Emily Sue Hamp | Counselor | 1202 Woodlake Dr, Santa Rosa, CA 95405-9217 | 2019-11-13 |
| 1316410640 | Lionel C Cooper | Counselor | 315 Mark West Springs Road, Santa Rosa, CA 95403 | 2019-01-09 |
| 1174005540 | Amal Saeed Ahmed | Counselor | 2908 Bay Village Cir Apt 2108, Santa Rosa, CA 95403-3611 | 2018-09-03 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1992223192 | Jill Mcculloch | Counselor | 300 Stony Point Rd Apt 190, Santa Rosa, CA 95401-5960 | 2017-09-07 |
| 1497299325 | Janice Anne Myers | Counselor | 3746 Oregon Dr, Santa Rosa, CA 95405-7136 | 2016-12-12 |
| 1689128001 | Wakanda Rose | Counselor | 254 Brey Rd, Santa Rosa, CA 95409-5556 | 2016-08-15 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on MS. DEBRA J KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.