Kenneth Bryan Kelso, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT88603 Issued in CA

Practice address

845 McCauley Way
Galt, CA 95632-8336

Phone

(916) 532-0074

NPI assigned

Jul 14, 2016

Last updated

Jul 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Bryan Kelso Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1184077190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 MCCAULEY WAY",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956328336",
            "telephone_number": "916-532-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 MCCAULEY WAY",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956328336",
            "telephone_number": "916-532-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "KENNETH",
        "middle_name": "BRYAN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT88603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYAN",
            "last_name": "KELSO",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Marriage & Family Therapist in Galt, CA
• Providers in Galt, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.