Provider Demographics
NPI:1396025094
Name:KEHOE, KELSEY ANN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANN
Last Name:KEHOE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 CAPISTRANO AVE STE E
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-7227
Mailing Address - Country:US
Mailing Address - Phone:805-674-2658
Mailing Address - Fax:
Practice Address - Street 1:5955 CAPISTRANO AVE STE E
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-7227
Practice Address - Country:US
Practice Address - Phone:805-674-2658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC49555106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist