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1063878130
SHAYNE THOMAS KELLEY
THOUSAND OAKS, CA
NPI
1063878130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date
2016-01-05
Last Update Date
2024-04-25
Business Address
Mr. SHAYNE THOMAS KELLEY
187 E WILBUR RD STE 14
THOUSAND OAKS, CA 91360-7938
Phone number: 818-253-4150
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Mailing Address
Mr. SHAYNE THOMAS KELLEY
187 E WILBUR RD STE 14
THOUSAND OAKS, CA 91360-7938
Phone number: 818-253-4150
Copy
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