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KELLY FERREIRA
NPI 1629445085
Substance Abuse Rehabilitation Facility in Crockett, CA

Active since September 01, 2015
715 PORT ST APT 2, CROCKETT, CA 94525(510) 860-6324 Get Directions Write a Review

NPPES record last updated: September 1, 2015. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Kelly Ferreira NPPES

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

KELLY FERREIRA (NPI 1629445085) is an individual substance abuse rehabilitation facility provider in Crockett, California, licensed in California (C2080275) and active in the NPI registry since September 2015.

NPPES Registry Identity

NPI1629445085
Entity TypeIndividualMale
Primary Taxonomy324500000X
Provider Legal NameKELLY FERREIRA
Location Address715 PORT ST APT 2Crockett, CA 94525-1120
Mailing Address715 Port St Apt 2Crockett, CA 94525-1120 · (510) 860-6324
Phone(510) 860-6324
Sole ProprietorYes
Enumeration DateSeptember 1, 2015
✔ NPI 1629445085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in CA · C2080275
Definition
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.
715 PORT ST APT 2, Crockett, CA 94525
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Other Identifiers 1

MedicaidC2080275CA

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 Kelly Ferreira's NPI number?

The NPI number for Kelly Ferreira is 1629445085. It was assigned to this individual provider in the NPPES registry on September 1, 2015.

Where is Kelly Ferreira located?

Kelly Ferreira practices at 715 Port St Apt 2, Crockett, CA 94525. The listed phone number is (510) 860-6324.

What is Kelly Ferreira's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Kelly Ferreira was last updated on September 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.