Most Relevant Information
Provider Data
| NPI Number: | 1003278797 |
| Provider Name: | DEBRA A. KELLY MFT, BCBA |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | MFC 35691 |
Most Important Dates
| Enumeration Date: | 03/22/2016 |
| Last Updated: | 04/14/2022 |
Provider Practice Location
29122 RANCHO VIEJO RD STE 206
SAN JUAN CAPISTRANO
CA
926751039
Practice Location Phone/Fax
| Phone: | 9493350254 |
| Fax: | 4938833109 |
Provider Mailing Location
8787 COMPLEX DR STE 300
SAN DIEGO
CA
921231453
Provider Mailing Phone/Fax
| Phone: | 1979710906 |
| Fax: | 8584448827 |