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General NPI Number Information
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NPI Number | 1194313817
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Entity Type | Individual
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Provider Name | AARON KELLOGG
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Gender | Male
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 4521 SHERMAN OAKS AVE
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-3807
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Country | US
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Telephone | 818-849-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 25011 MAGIC MOUNTAIN PKWY APT 114
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City | VALENCIA
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State | CA
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Zip | 91355-4677
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Country | US
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Telephone | 661-289-1354
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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 | 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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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 129732
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License Number State | CA
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