Provider Demographics
NPI:1831249762
Name:KELLEY, BRITTANY WILKINSON (MSW)
Entity type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:WILKINSON
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ANNE
Other - Last Name:WILKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:8600 FOUNTAIN BLUE CT
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8568
Mailing Address - Country:US
Mailing Address - Phone:707-649-5057
Mailing Address - Fax:
Practice Address - Street 1:8600 FOUNTAIN BLUE CT
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-8568
Practice Address - Country:US
Practice Address - Phone:707-649-5057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA195981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical