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NPI Code Detail

MEDICARE: KERI O'CALLAGHAN

MEDICARE: KERI O'CALLAGHAN
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
1103K00000XBehavior Analyst1-16-24163CA

General Provider Information

NPI Number : 1568900702
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERI O'CALLAGHAN
Provider Business Mailing Address
First Line : 5850 GRANITE PKWY STE 600
Second Line :
City : PLANO
State : TX
Zip : 75024-6753
Country : US
Telephone Number : 469-694-1754
Fax Number : 818-758-8015
Provider Business Practice Location Address
First Line : 5168 N BLYTHE AVE STE 102
Second Line :
City : FRESNO
State : CA
Zip : 93722-6478
Country : US
Telephone Number : 559-255-5900
Fax Number : 559-981-1212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2017
Last Update Date : 08/10/2022

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Directions to “ KERI O'CALLAGHAN ” Practice Location

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