Active NPI
Keller Lee Rich, LMFT
- Marriage & Family Therapist
- San Diego, CA
National Provider Identifier
1194163774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 95120
- Practice address
- 5060 Shoreham PL Ste 100
San Diego, CA 92122-5904 - Phone
- (858) 221-0344
- Fax
- (949) 703-7489
- NPI assigned
- Jun 5, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 95120 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5060 Shoreham PL Ste 100
San Diego, CA 92122-5904
Mailing address
5060 Shoreham PL Ste 100
San Diego, CA 92122-5904
Phone (858) 221-0344
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | practicefusion |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Dec 18, 2024 through Dec 18, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95120 | CA | MD | Marriage & Family Therapist |
Interoperability endpoints
- https://api.platform.athenahealth.com/21563/brand/1/csg/1/fhir/r4
- keller.rich.p1@direct.sokya.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724803200000",
"number": "1194163774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5060 SHOREHAM PL STE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921225904",
"telephone_number": "858-221-0344",
"fax_number": "949-703-7489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5060 SHOREHAM PL STE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921225904",
"telephone_number": "858-221-0344",
"fax_number": "949-703-7489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICH",
"first_name": "KELLER",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-05",
"last_updated": "2024-08-28",
"certification_date": "2024-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "95120",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "practicefusion",
"affiliation": "N",
"address_1": "4510 Executive Dr",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921213021",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.