Individual provider Active NPI

Michael Scott Keesler

  • Marriage & Family Therapist
  • Valencia, CA
National Provider Identifier
1972154169
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT111074 Issued in CA
Practice address
23822 Valencia Blvd Ste 207
Valencia, CA 91355-5348
Phone
(661) 437-3287
Fax
(661) 244-3513
NPI assigned
Sep 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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 AMFT111074 CA Primary

Addresses

Primary practice location

23822 Valencia Blvd Ste 207
Valencia, CA 91355-5348

Mailing address

27952 Agapanthus LN
Valencia, CA 91354-4927
Phone (949) 433-7788

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

LicenseStateTypeSpecialty
AMFT111074CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Judd Psychological Services Inc CurrentSince Aug 15, 2020 Accepting new patients

Locations

23822 Valencia Blvd
Ste 207
Valencia, CA 91355
Phone (661) 437-3287

Organizations & group practices 1

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": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1972154169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27952 AGAPANTHUS LN",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913544927",
            "telephone_number": "949-433-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23822 VALENCIA BLVD STE 207",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913555348",
            "telephone_number": "661-437-3287",
            "fax_number": "661-244-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEESLER",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT111074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.