Healthcare Provider Details

I. General information

NPI: 1316389992
Provider Name (Legal Business Name): JAMI L KERR MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 12/08/2019
Certification Date: 12/08/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CARMEN DR STE 215-I
CAMARILLO CA
93010-3105
US

IV. Provider business mailing address

1601 CARMEN DR STE 215-I
CAMARILLO CA
93010-3105
US

V. Phone/Fax

Practice location:
  • Phone: 805-312-7615
  • Fax: 805-383-3692
Mailing address:
  • Phone: 805-312-7615
  • Fax: 805-383-3692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPSB94023944
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: