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NPI Code Detail

MEDICARE: KELSEY KILPONEN MSW

MEDICARE: KELSEY KILPONEN MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1245724608
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY KILPONEN MSW
Provider Business Mailing Address
First Line : 530 58TH ST UNIT A
Second Line :
City : OAKLAND
State : CA
Zip : 94609-1526
Country : US
Telephone Number : 973-223-7124
Fax Number :
Provider Business Practice Location Address
First Line : 2045 FAIRMONT DR
Second Line :
City : CASTRO VALLEY
State : CA
Zip : 94578-1088
Country : US
Telephone Number : 510-433-8600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2018
Last Update Date : 06/03/2025

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