KELLY FERREIRA NPI 1629445085

NPI Information

  • NPI: 1629445085
  • Provider Name: KELLY FERREIRA
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Individual
  • Address: 715 PORT ST APT 2
    CROCKETT, CA
    ZIP 94525
  • Phone: (510) 860-6324

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NPI Details

Kelly Ferreira is a substance abuse rehabilitation facility in Crockett, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. Kelly Ferreira NPI is 1629445085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

715 PORT ST APT 2
CROCKETT, CA
ZIP 94525-120
Phone: (510) 860-6324

The enumeration date for this NPI number is 9/1/2015 and was last updated on 9/1/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityC2080275CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C2080275MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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