Individual provider · Type 1 NPI

Manny Brice Kelly, LPT

Licensed Psychiatric Technician · San Bernardino, CA

NPI number 1003479320 Active

Practice location

1481 Windsor Dr
San Bernardino, CA 92404-5416

Call (909) 361-6472 Map

Fax (909) 203-7403

Mailing address

2895 W Fairview Dr
Rialto, CA 92377-3425

Specialties and licenses

TaxonomyCodeLicense
Licensed Psychiatric Technician Primary 167G00000X33817 (CA)

Licensed Psychiatric Technician: An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental dis…

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About NPI 1003479320

Manny Brice Kelly, LPT's National Provider Identifier is 1003479320, issued on Apr 22, 2019. The primary taxonomy on file is Licensed Psychiatric Technician (167G00000X), and the practice location is in San Bernardino, CA. The record was last updated on Apr 22, 2019.