Provider Demographics
NPI:1043302086
Name:KELFER, BRANDI
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:
Last Name:KELFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3437 MYRTLE AVE
Mailing Address - Street 2:#420
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-5145
Mailing Address - Country:US
Mailing Address - Phone:916-338-6835
Mailing Address - Fax:
Practice Address - Street 1:3437 MYRTLE AVE
Practice Address - Street 2:#420
Practice Address - City:NORTH HIGHLANDS
Practice Address - State:CA
Practice Address - Zip Code:95660-5145
Practice Address - Country:US
Practice Address - Phone:916-338-6835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0000000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)