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General NPI Number Information
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NPI Number | 1730892829
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Entity Type | Individual
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Provider Name | KELLY HOWARD AMFT
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Gender | Female
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 360 GRAND AVE # 46
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City | OAKLAND
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State | CA
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Zip | 94610-4840
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Country | US
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Telephone | 510-394-5065
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Fax |
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Provider Business Mailing Address
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Address Line | 2930 DOMINGO AVE # 1472
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City | BERKELEY
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State | CA
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Zip | 94705-2454
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Country | US
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Telephone | 510-629-1430
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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 | 144916
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License Number State | CA
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