Provider Demographics
NPI:1134313984
Name:MCKELVEY, KIRK PATRICK (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:PATRICK
Last Name:MCKELVEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3319 M ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2714
Mailing Address - Country:US
Mailing Address - Phone:209-385-3585
Mailing Address - Fax:209-385-3578
Practice Address - Street 1:3319 M ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2714
Practice Address - Country:US
Practice Address - Phone:209-385-3585
Practice Address - Fax:209-385-3578
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24277103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical