Provider Demographics
NPI:1013622844
Name:FLEMING, KELVIN DONYELL SR (MA)
Entity Type:Individual
Prefix:MR
First Name:KELVIN
Middle Name:DONYELL
Last Name:FLEMING
Suffix:SR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 RIESLING ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-6362
Mailing Address - Country:US
Mailing Address - Phone:951-447-3744
Mailing Address - Fax:
Practice Address - Street 1:763 RIESLING ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-6362
Practice Address - Country:US
Practice Address - Phone:951-447-3744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling