Provider Demographics
NPI:1366847626
Name:FORRESTER, KELLI (ACSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:
Last Name:FORRESTER
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 NAPA VALLEY CORP DRIVE BLD A
Mailing Address - Street 2:SUITE A
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-9613
Mailing Address - Country:US
Mailing Address - Phone:707-299-1757
Mailing Address - Fax:707-299-2120
Practice Address - Street 1:2751 NAPA VALLEY CORPORATE DR BLDG A
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6216
Practice Address - Country:US
Practice Address - Phone:707-299-1757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health