JACQUELINE KELLY
NPI 1235077694
Nurse Practitioner - Family in Lakeport, CA

Active since March 24, 2026
925 BEVINS CT, LAKEPORT, CA 95453(707) 263-8382 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jacqueline Kelly NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE KELLY (NPI 1235077694) is an individual family provider in Lakeport, California, licensed in California (F02260054) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1235077694
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJACQUELINE KELLY
Location Address925 BEVINS CTLakeport, CA 95453-9754
Mailing AddressPo Box 516Clearlake Oaks, CA 95423-0516 · (916) 613-0098
Sole ProprietorNo
Enumeration DateMarch 24, 2026
NPPES CertifiedMarch 24, 2026
NPI 1235077694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in CA · F02260054
925 BEVINS CT, Lakeport, CA 95453

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
925 BEVINS CT
LAKEPORT, CA 95453
Registered Nurse (General Practice)
925 BEVINS CT
LAKEPORT, CA 95453
Health Educator
925 BEVINS CT
LAKEPORT, CA 95453
Registered Nurse (Administrator)
925 BEVINS CT
LAKEPORT, CA 95453
Dentist
925 BEVINS CT
LAKEPORT, CA 95453
Marriage & Family Therapist
925 BEVINS CT
LAKEPORT, CA 95453
Nurse Practitioner
925 BEVINS CT
LAKEPORT, CA 95453
Physical Therapist
925 BEVINS CT
LAKEPORT, CA 95453

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Kelly's NPI number?

The NPI number for Jacqueline Kelly is 1235077694. It was assigned to this individual provider in the NPPES registry on March 24, 2026.

Where is Jacqueline Kelly located?

Jacqueline Kelly practices at 925 Bevins Ct, Lakeport, CA 95453. The listed phone number is (707) 263-8382.

What is Jacqueline Kelly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Jacqueline Kelly was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.