Provider Demographics
NPI:1093691933
Name:WEST, KELSIE B
Entity type:Individual
Prefix:MS
First Name:KELSIE
Middle Name:B
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 KEYSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:CA
Mailing Address - Zip Code:95363-8861
Mailing Address - Country:US
Mailing Address - Phone:209-895-7700
Mailing Address - Fax:
Practice Address - Street 1:610 N HARTLEY ST
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363-2475
Practice Address - Country:US
Practice Address - Phone:209-895-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1EE8FDC225171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach