Provider Demographics
NPI:1922992742
Name:KELISON, MARY CAY (DOULA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CAY
Last Name:KELISON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 TIFFANY WEST WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1426
Mailing Address - Country:US
Mailing Address - Phone:206-714-5277
Mailing Address - Fax:
Practice Address - Street 1:2712 TIFFANY WEST WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1426
Practice Address - Country:US
Practice Address - Phone:206-714-5277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula