Provider Demographics
NPI:1417346958
Name:NEELY, FRANCES WELLS (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:WELLS
Last Name:NEELY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40043 97TH ST W
Mailing Address - Street 2:
Mailing Address - City:LEONA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93551-7321
Mailing Address - Country:US
Mailing Address - Phone:661-916-9367
Mailing Address - Fax:
Practice Address - Street 1:40043 97TH ST W
Practice Address - Street 2:
Practice Address - City:LEONA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93551-7321
Practice Address - Country:US
Practice Address - Phone:661-916-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 7266103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical