Provider Demographics
NPI:1578210522
Name:NEUFELD, KELLEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:
Last Name:NEUFELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 COCO PALMS DR
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1641
Mailing Address - Country:US
Mailing Address - Phone:315-368-7872
Mailing Address - Fax:
Practice Address - Street 1:2525 PIO PICO DR STE 301
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1568
Practice Address - Country:US
Practice Address - Phone:760-445-6840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1066241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical