Kelly A Keller, FNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

12688 Issued in CA

Practice address

420 Whitehall Rd Apt B
Alameda, CA 94501-6135

Phone

(510) 589-9902

Fax

(510) 263-8565

NPI assigned

Jun 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Kadari Keller Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• La Cheim School, Inc.

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1275881492
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1952307381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 WHITEHALL RD",
            "address_2": "UNIT B",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016135",
            "telephone_number": "510-589-9902",
            "fax_number": "510-263-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 WHITEHALL RD APT B",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945016135",
            "telephone_number": "510-589-9902",
            "fax_number": "510-263-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLER",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "12688",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "12688",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "12688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KADARI",
            "last_name": "KELLER",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shivinder B Kaur, MD
• Ten Kay, L.AC
• Joshua Edward Kayman, M.D
• KCG Physical Therapy and Wellness SVCS, Inc
• Ann Keilman, LCSW
• Ken Chen Optometry Inc
• Calista Kendrick
• Robbie Kupono Kenobi, LCSW
• Amanda Kensinger, RN
• Taylor Mitchell Kent, D.D.S

• Psychiatric/Mental Health Nurse Practitioner in Alameda, CA
• Providers in Alameda, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2016; 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.