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General NPI Number Information
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NPI Number | 1750861522
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Entity Type | Individual
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Provider Name | KELBY KATZ
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Gender | Male
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 575 S RENGSTORFF AVE APT 80
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040
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Country | US
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Telephone | 786-897-4354
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 S EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94402-2801
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Country | US
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Telephone |
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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 | CA
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