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General NPI Number Information
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NPI Number | 1750768933
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Entity Type | Individual
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Provider Name | SKYE KEELEY-SHEA INNERARITY M.A.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 285 4TH ST
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City | WOODLAND
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State | CA
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Zip | 95695-3501
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Country | US
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Telephone | 530-662-2699
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Fax |
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Provider Business Mailing Address
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Address Line | 2618 J ST SUITE 2
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City | SACRAMENTO
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State | CA
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Zip | 95816-4360
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Country | US
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Telephone | 916-690-5168
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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 | IMF84164
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License Number State | CA
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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 | 104388
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License Number State | CA
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