Healthcare Provider Details

I. General information

NPI: 1508778119
Provider Name (Legal Business Name): KELLEN ATKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26623 MAY WAY
SANTA CLARITA CA
91351-5577
US

IV. Provider business mailing address

26623 MAY WAY
SANTA CLARITA CA
91351-5577
US

V. Phone/Fax

Practice location:
  • Phone: 661-250-0022
  • Fax:
Mailing address:
  • Phone: 661-250-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: