Individual provider Active NPI

Kathleen Keilman

  • Clinical Social Worker
  • Marina, CA
National Provider Identifier
1255766515
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW89032 Issued in CA
Practice address
299 12TH St Ste a
Marina, CA 93933-6003
Phone
(831) 647-7652
NPI assigned
Sep 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LCSW89032 CA Primary

Addresses

Primary practice location

299 12TH St Ste a
Marina, CA 93933-6003

Mailing address

299 12TH St Ste a
Marina, CA 93933-6003
Phone (831) 647-7652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331003205 CA Practitioner - Clinical Social Worker 1153750831 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW89032CAMDClinical Social Worker
89032CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Monterey Behavioral Health CurrentSince Nov 12, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1255766515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 12TH ST STE A",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939336003",
            "telephone_number": "831-647-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 12TH ST STE A",
            "city": "MARINA",
            "state": "CA",
            "postal_code": "939336003",
            "telephone_number": "831-647-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEILMAN",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW89032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marina, CA

Sources for this page

Verify at the official NPI Registry.