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NPI Code Detail

MEDICARE: KELLEY WEB ACSW

MEDICARE: KELLEY WEB ACSW
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
1104100000XSocial WorkerASW135914CA

General Provider Information

NPI Number : 1356272298
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY WEB ACSW
Provider Business Mailing Address
First Line : 2116 ARLINGTON AVE STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-1300
Country : US
Telephone Number : 323-334-9000
Fax Number : 323-334-4437
Provider Business Practice Location Address
First Line : 2116 ARLINGTON AVE STE 100
Second Line :
City : LOS ANGELES
State : CA
Zip : 90018-1300
Country : US
Telephone Number : 323-334-9000
Fax Number : 323-334-4437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2026
Last Update Date : 05/28/2026

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Directions to “ KELLEY WEB ACSW” Practice Location

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