Active NPI
Clifford Keith
- Counselor
- Carson, CA
National Provider Identifier
1669604120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 190600AP
- Practice address
- 637 E Albertoni St
#109
Carson, CA 90746-1539 - Phone
- (213) 820-1511
- Fax
- (310) 626-9754
- NPI assigned
- Aug 18, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 190600AP | CA | Primary |
Addresses
Primary practice location
637 E Albertoni St
#109
Carson, CA 90746-1539
Mailing address
637 E Albertoni St
#109
Carson, CA 90746-1539
Phone (213) 820-1511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190600AP | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250553600000",
"number": "1669604120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "637 E ALBERTONI ST",
"address_2": "#109",
"city": "CARSON",
"state": "CA",
"postal_code": "907461539",
"telephone_number": "213-820-1511",
"fax_number": "310-626-9754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "637 E ALBERTONI ST",
"address_2": "#109",
"city": "CARSON",
"state": "CA",
"postal_code": "907461539",
"telephone_number": "213-820-1511",
"fax_number": "310-626-9754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEITH",
"first_name": "CLIFFORD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-18",
"last_updated": "2009-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "190600AP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.