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1386094993
JAKE KELLY
WASCO, CA
NPI
1386094993
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TF0200X Psychologist Forensic
Enumeration Date
2016-06-14
Last Update Date
2016-06-14
Business Address
DR. JAKE KELLY
701 SCOFIELD AVE
WASCO, CA 93280-7515
Phone number: 661-758-8400
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Mailing Address
DR. JAKE KELLY
425 ESTANCIA
IRVINE, CA 92602-1108
Phone number: 408-505-0654
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