Provider Demographics
NPI:1972950277
Name:KELSEY, JOHN (JD, MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:KELSEY
Suffix:
Gender:M
Credentials:JD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 SACRAMENTO ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2328
Mailing Address - Country:US
Mailing Address - Phone:216-246-7624
Mailing Address - Fax:
Practice Address - Street 1:2323 SACRAMENTO ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2328
Practice Address - Country:US
Practice Address - Phone:216-246-7624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1531072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program