Healthcare Provider Details

I. General information

NPI: 1316592827
Provider Name (Legal Business Name): KELLI BROWER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2019
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N PERRIS BLVD
PERRIS CA
92571-2811
US

IV. Provider business mailing address

555 N PERRIS BLVD
PERRIS CA
92571-2811
US

V. Phone/Fax

Practice location:
  • Phone: 951-436-5300
  • Fax: 951-436-5352
Mailing address:
  • Phone: 951-436-5300
  • Fax: 951-436-5352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number137340
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: