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NPI Code Detail

MEDICARE: DR. KELLI ANN RULE PSY.D

MEDICARE: DR. KELLI ANN RULE PSY.D
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
1103TC0700XClinical PsychologistPSY30541CA
2103T00000XPsychologist30541CA

General Provider Information

NPI Number : 1538568134
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLI ANN RULE PSY.D
Provider Business Mailing Address
First Line : 2828 COCHRAN ST # 240
Second Line :
City : SIMI VALLEY
State : CA
Zip : 93065-2780
Country : US
Telephone Number : 805-624-2121
Fax Number :
Provider Business Practice Location Address
First Line : 176 HOLSTON DR
Second Line :
City : LANCASTER
State : CA
Zip : 93535-4531
Country : US
Telephone Number : 213-247-0594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2014
Last Update Date : 06/16/2022

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