Provider Demographics
NPI:1114036753
Name:KESLER, PAMELA J (MFT)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:KESLER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 MAPLE STREET, UNIT C.
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5008
Mailing Address - Country:US
Mailing Address - Phone:530-888-7958
Mailing Address - Fax:530-888-7999
Practice Address - Street 1:152 MAPLE STREET, UNIT C.
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603
Practice Address - Country:US
Practice Address - Phone:530-888-7958
Practice Address - Fax:530-888-7999
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN244744163W00000X
CAMFC37603106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163W00000XNursing Service ProvidersRegistered Nurse