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General NPI Number Information
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NPI Number | 1225854086
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Entity Type | Individual
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Provider Name | KELSEY J TARGOSZ M.S. PPS
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Gender | Female
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | MEYERS ELEMENTARY SCHOOL 1095 E SAN BERNARDINO AVE
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City | S LAKE TAHOE
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State | CA
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Zip | 96150-5235
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Country | US
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Telephone | 530-543-2371
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 AL TAHOE BLVD
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City | S LAKE TAHOE
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State | CA
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Zip | 96150-4502
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Country | US
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Telephone | 530-543-2371
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | CA
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