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DR. KELLY E. BRODETSKY PHARMD
NPI 1659446540
Pharmacist in Mendocino, CA

Active since November 24, 2006
10501 LANSING STREET, #904, MENDOCINO, CA 95460(707) 937-4800(707) 937-5800 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Dec 29, 2017 (2 updates tracked since 2017).

About Dr. Kelly E. Brodetsky Pharmd NPPES

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

DR. KELLY E. BRODETSKY PHARMD (NPI 1659446540) is an individual pharmacist in Mendocino, California, licensed in California (PHY45989) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1659446540
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameDR. KELLY E. BRODETSKYCredential: PHARMD
Location Address10501 LANSING STREET, #904Mendocino, CA 95460-0904
Mailing AddressPo Box 904Mendocino, CA 95460-0904 · (707) 937-4800 · Fax (707) 937-5800
Phone(707) 937-4800
Fax(707) 937-5800
Sole ProprietorYes
Enumeration DateNovember 24, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
✔ NPI 1659446540 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in CA · PHY45989
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
10501 LANSING STREET, Mendocino, CA 95460
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Other Identifiers 4

OtherPHY45989CA · State License Number
Other412046786CA · Federal Tax Id
Other0582292CA · Ncpdp Number
MedicaidPHA459890CA

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 Brodetsky's NPI number?

The NPI number for Kelly Brodetsky is 1659446540. It was assigned to this individual provider in the NPPES registry on November 24, 2006.

Where is Kelly Brodetsky located?

Kelly Brodetsky practices at 10501 Lansing Street #904, Mendocino, CA 95460. The listed phone number is (707) 937-4800.

What is Kelly Brodetsky's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Kelly Brodetsky was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.