Jordan Keel

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1919 Addison St
Berkeley, CA 94704-1141

Phone

(510) 714-0996

NPI assigned

Jan 12, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1306617865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13939 E 14TH ST STE 190",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945782601",
            "telephone_number": "510-714-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 ADDISON ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041141",
            "telephone_number": "510-714-0996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13939 E 14th St Ste 190",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945782601",
            "country_code": "US",
            "telephone_number": "510-714-0996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2640 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947043238",
            "country_code": "US",
            "telephone_number": "510-714-0996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEL",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Brenna Keane
• Michael Edward Kearns
• Teddy Kebede, RN, PHN
• Denise Kee-White, LCSW
• Shannon Keefe, MS
• Keith T. Nelson, DDS Inc
• Mirjana Kelava, PH.D.
• Lisa J Kelleher, LMFT
• Robin S Keller, PHD
• Gabriella Kellerman, M.D

• Specialist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.