Active NPI
Bethany Alice Keener, M.S., OTR/L
- Occupational Therapist
- Oakland, CA
National Provider Identifier
1083051619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13484
- Practice address
- 2780 26TH Ave
Oakland, CA 94601-1911 - Phone
- (510) 536-1838
- NPI assigned
- May 22, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13484 | CA | Primary |
Addresses
Primary practice location
2780 26TH Ave
Oakland, CA 94601-1911
Mailing address
2728 Prince St
Berkeley, CA 94705-2613
Phone (201) 819-5569
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13484 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1083051619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2728 PRINCE ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947052613",
"telephone_number": "201-819-5569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2780 26TH AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946011911",
"telephone_number": "510-536-1838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEENER",
"first_name": "BETHANY",
"middle_name": "ALICE",
"name_prefix": "Mrs.",
"credential": "M.S., OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-22",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "13484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.