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General NPI Number Information
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NPI Number | 1952952681
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Entity Type | Individual
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Provider Name | KELLI ANN DAHER BA
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Gender | Female
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 3600 GLEN CANYON RD
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-4923
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Country | US
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Telephone | 831-227-2424
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 GLEN CANYON RD
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-4923
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Country | US
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Telephone | 831-227-2424
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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 | AMFT149389
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APCC17380
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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