Melton Ray Keith Jr.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1438570721 Issued in CA

Practice address

4343 Williamsbourgh Dr
Sacramento, CA 95823-2006

Phone

(915) 395-3552

NPI assigned

Oct 8, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jr Keith Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1124780986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5312 VALHALLA DR",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956081243",
            "telephone_number": "916-517-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 WILLIAMSBOURGH DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232006",
            "telephone_number": "915-395-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "MELTON",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1438570721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JR",
            "last_name": "KEITH",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jonathan Kei, MD
• Richard Craig Keilson, D.D.S.
• Tamara J Keisner
• Keith Liang, MD
• Jesse Lee Keith
• Mary Cay Kelison, DOULA
• Myah Kellam
• Peter Sean Kelleher, MPT
• Jackie Jenni Keller, PHD
• Josie Marleena Keller

• Addiction (Substance Use Disorder) Counselor in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.