Individual provider Active NPI

Kendall Hailey Keller, M.A.

  • Mental Health Counselor
  • Roseville, CA
National Provider Identifier
1740191287
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
164901 Issued in CA
Practice address
3017 Douglas Blvd Ste 300
Roseville, CA 95661-3850
Phone
(855) 500-6463
NPI assigned
Sep 14, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 164901 CA Primary

Addresses

Primary practice location

3017 Douglas Blvd Ste 300
Roseville, CA 95661-3850

Mailing address

10 Declaration Dr
Chico, CA 95973-4931
Phone (855) 500-6463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1740191287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DECLARATION DR",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734931",
            "telephone_number": "855-500-6463",
            "fax_number": "844-553-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 DOUGLAS BLVD STE 300",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613850",
            "telephone_number": "855-500-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KENDALL",
        "middle_name": "HAILEY",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-14",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "164901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.