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General NPI Number Information
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NPI Number | 1134308463
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Entity Type | Individual
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Provider Name | ROBERT ALAN KESSELRING MA, LPC, MFTI
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Gender | Male
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 1500 NORTH A STREET
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City | SACRAMENTO
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State | CA
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Zip | 95814-0712
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Country | US
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Telephone | 916-440-1500
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Fax | 916-440-1514
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Provider Business Mailing Address
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Address Line | PO BOX 221096
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City | SACRAMENTO
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State | CA
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Zip | 95822-8096
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Country | US
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Telephone | 734-255-4485
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401009133
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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