Healthcare Provider Details

I. General information

NPI: 1548187347
Provider Name (Legal Business Name): KELLI REA MARRIAGE & FAMILY THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 S CATALINA AVE STE 1
REDONDO BEACH CA
90277-5516
US

IV. Provider business mailing address

1921 S CATALINA AVE STE 1
REDONDO BEACH CA
90277-5516
US

V. Phone/Fax

Practice location:
  • Phone: 310-961-1608
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KELLI REA
Title or Position: PRESIDENT/CEO
Credential: LMFT
Phone: 310-961-1608