Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PSY27162 | CA |
N | 103T00000X | Psychologist | PSY27162 | CA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY27162 | CA |
N | 103TA0700X | Adult Development & Aging Psychologist | PSY27162 | |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY27162 | CA |
Y | 103G00000X | Clinical Psychologist | PSY27162 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY27162 | CA |
N | 103TF0000X | Family Psychologist | PSY27162 | CA |
N | 103TP0814X | Psychoanalysis | PSY27162 | CA |
N | 103TP2701X | Group Psychotherapist | PSY27162 | CA |
NPI | 1861879553 |
---|---|
Provider Name | Barbara Kelly Key |
First Address | Mission Viejo, CA 92691-4839 |
Second Address | Mission Viejo, CA 92691-4839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2015 |
Last Update Date | 01/05/2015 |