Individual provider Active NPI

Julie Anna Keller, LMFT

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1366098725
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1891241634 Issued in CA
Practice address
700 Gibson Dr Apt 1713
Roseville, CA 95678-5762
Phone
(775) 830-7739
NPI assigned
Aug 12, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1891241634 CA Primary

Addresses

Primary practice location

700 Gibson Dr Apt 1713
Roseville, CA 95678-5762

Mailing address

700 Gibson Dr Apt 1713
Roseville, CA 95678-5762
Phone (775) 830-7739

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
I20240304002352 CA Practitioner - Mental Health Counselor 6507201241 Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

700 Gibson Dr Apt
Suite 1713
Roseville, CA 95678-5762

901 Sunrise Ave
Suite A3
Roseville, CA 95661-4520
Phone (279) 219-9529

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1891241634CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Keller Care LMFT CurrentSince Oct 1, 2022 Accepting new patients
Environmental Alternatives Case Manager/Care Coordinator PastSince Aug 1, 2019 Accepting new patients

Locations

901 Sunrise Ave
Ste A3
Roseville, CA 95661
Phone (279) 219-9529

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1366098725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 GIBSON DR APT 1713",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785762",
            "telephone_number": "775-830-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 GIBSON DR APT 1713",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785762",
            "telephone_number": "775-830-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "JULIE",
        "middle_name": "ANNA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2024-06-10",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "1891241634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.