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General NPI Number Information
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NPI Number | 1720733272
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Entity Type | Individual
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Provider Name | KELSEY JUNE HERMANN APCC, PPS
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Gender | Female
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 4004 GLOSTER WAY
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City | SACRAMENTO
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State | CA
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Zip | 95834-2038
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Country | US
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Telephone | 916-928-5316
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Fax |
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Provider Business Mailing Address
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Address Line | 4004 GLOSTER WAY
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City | SACRAMENTO
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State | CA
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Zip | 95834-2038
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Country | US
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Telephone | 916-928-5316
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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 |
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License Number State |
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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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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11519
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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