Healthcare Provider Details

I. General information

NPI: 1033021225
Provider Name (Legal Business Name): KELLI K CAPITAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6490 CHURN CREEK RD
REDDING CA
96002-9107
US

IV. Provider business mailing address

6490 CHURN CREEK RD
REDDING CA
96002-9107
US

V. Phone/Fax

Practice location:
  • Phone: 530-691-2269
  • Fax:
Mailing address:
  • Phone: 530-691-2269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLI MARIE HAYWARD
Title or Position: OWNER AND MANAGING MEMBER
Credential:
Phone: 530-510-2448