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General NPI Number Information
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NPI Number | 1275156374
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Entity Type | Individual
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Provider Name | JOSEPHINE KELLY MSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 533A CASTRO ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-2511
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Country | US
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Telephone | 415-766-0276
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 548
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City | BLUE LAKE
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State | CA
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Zip | 95525-0548
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Country | US
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Telephone | 510-394-2825
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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