Kellie Vaca
Social Worker, Clinical in Los Angeles, CA. Individual provider (NPI-1).
NPI number1396294591
StatusActive
Last updated in NPPESMar 10, 2022
Details
- NPI
- 1396294591
- Entity type
- Individual (NPI-1)
- Name
- Kellie Vaca
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2016
- Certification date
- Mar 10, 2022
- Last updated
- Mar 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 83763 | CA | Yes |
| 101YM0800X | Counselor, Mental Health | 83763 | CA | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
7120 Franklin AveLos Angeles, CA 90046-3002
Phone 323-876-0550
Mailing address
10155 Colima RdWhittier, CA 90603-2042
Phone 562-692-0383
Other practice locations
855 N Orange Grove Blvd
Pasadena, CA 91103-3333
Pasadena, CA 91103-3333
Phone 626-796-3453
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