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General NPI Number Information
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NPI Number | 1174471619
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Entity Type | Individual
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Provider Name | KELLY STONE
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Gender | Female
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Dates
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Enumeration Date | 03/19/2026
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Last Update Date | 03/19/2026
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Provider Practice Location Address
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Address Line | 130 W KINGSBRIDGE RD
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City | BRONX
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State | NY
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Zip | 10468-3904
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Country | US
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Telephone | 206-890-9113
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Fax |
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Provider Business Mailing Address
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Address Line | 833 SAN JOSE AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-5421
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | NONE
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License Number State | CA
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