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General NPI Number Information
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NPI Number | 1043349152
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Entity Type | Individual
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Provider Name | BARBARA H. KELLY PHD
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 2645 1ST AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-6506
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Country | US
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Telephone | 619-890-8491
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Fax | 619-435-1456
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Provider Business Mailing Address
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Address Line | 1810 AVENIDA DEL MUNDO UNIT 807
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City | CORONADO
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State | CA
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Zip | 92118-3003
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Country | US
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Telephone | 619-890-8491
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Fax | 619-435-1456
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY18148
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License Number State | CA
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