Provider Demographics
NPI:1316389992
Name:KERR, JAMI L (MS)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:L
Last Name:KERR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CARMEN DR STE 215-I
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3105
Mailing Address - Country:US
Mailing Address - Phone:805-312-7615
Mailing Address - Fax:805-383-3692
Practice Address - Street 1:1601 CARMEN DR STE 215-I
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3105
Practice Address - Country:US
Practice Address - Phone:805-312-7615
Practice Address - Fax:805-383-3692
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94023944101YM0800X
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA174400000XOtherREHAB ACTIVITY LEADER