MARY KELLER (NPI# 1205453560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205453560 |
| Entity Type | Individual |
| Full Name | MARY KELLER |
| Practice Address |
3853 Rosecrans St San Diego CA 92110-3115 |
| Practice Telephone | 6196928232 |
| Mailing Telephone | 6196928232 |
| Mailing Fax Number | 6195424060 |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-07-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
95210461 | CA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437475258 | Mary Jane Keller | Counselor | 3100 Carlisle, Suite 109, Dallas, TX 75204 | 2010-04-19 |
| 1154523595 | Mary L Keller | Pharmacist | 6600 Ne 112th Court, Ste 103, Vancouver, WA 98662 | 2007-06-05 |
| 1326129867 | Mary Jane Keller | Occupational Therapist | 8554 Hwy 51 N, Unit 617, Minocqua, WI 54548 | 2006-10-18 |
| 1245622752 | Mary Keller | Counselor | 1944 Brannan Rd, Mcdonough, GA 30253-4310 | 2015-02-21 |
| 1356663587 | Mary Louise Keller | Physician Assistant | 4000 S Swaim Street Ext, Jonesville, NC 28642-9418 | 2010-02-15 |
| 1073702866 | Mary Ramsey Keller | Dietitian, Registered | 1801 Oak Park Blvd, Lake Charles, LA 70601-8900 | 2007-10-17 |
| 1932397254 | Mary Keller | Registered Nurse | 2250 Hickory Rd, Suite 240, Plymouth Meeting, PA 19462-1047 | 2007-10-11 |
| 1073678033 | Mary Jean Keller | Nurse Practitioner | 3525 S National Ave Ste 207, Springfield, MO 65807-7315 | 2006-12-27 |
| 1386722650 | Mary A Keller | Counselor | 671 Hoes Ln, Piscataway, NJ 08854-5627 | 2006-11-02 |
| 1992727259 | Mary Margaret Keller | Nurse Practitioner | 2901 W Kinnickinnic River Pkwy Ste 413, Milwaukee, WI 53215-3660 | 2006-07-24 |
| Street Address |
3853 ROSECRANS ST |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92110-3115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750490645 | Nicole Marie Lanouette | Psychiatry & Neurology | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2006-08-30 |
| 1396345260 | Jamson Jaeger Deloria Abella | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-10-29 |
| 1588262158 | Kyle Alvin Pedines Marmolejo | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-10-15 |
| 1972101129 | Robert James Dodson | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-10-10 |
| 1114524402 | Ma Rosa Nika Z Paet | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-10-08 |
| 1164029740 | Charmaine Lim Solmerano | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-10-06 |
| 1609483858 | Bethany Anne Higgins | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-09-30 |
| 1972110609 | Shannon M Keene | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-09-27 |
| 1396352449 | Connor Louis Kleis | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-09-23 |
| 1396351284 | Lourdes Marie Terry | Registered Nurse | 3853 Rosecrans St, San Diego, CA 92110-3115 | 2020-09-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669021713 | Ruben Daniel Gutierrez | Marriage & Family Therapist | 4141 Pacific Coast Hwy, San Diego, CA 92110 | 2019-09-10 |
| 1548724081 | Denise Ellen Thompson | Counselor | 3255 Wings Street, San Diego, CA 92110 | 2019-01-29 |
| 1801378716 | Michelle Lisa Jean Crawford | Student in an Organized Health Care Education/Training Program | 3767 Central Avenue, San Diego, CA 92110 | 2018-09-06 |
| 1427539048 | Allison Turrell | Case Manager/Care Coordinator | 4930 Naples Street, San Diego, CA 92110 | 2018-08-22 |
| 1750872768 | Matthew Langworthy | Physical Therapist | 3405 Kenyon St Ste 212, San Diego, CA 92110 | 2018-05-24 |
| 1245748342 | The One Health Boutique, LLC | Chiropractor | 5350 Riley St, San Diego, CA 92110 | 2018-01-11 |
| 1437670155 | Monique A Fernandez | Counselor | 3132 Jefferson Street, San Diego, CA 92110 | 2017-07-03 |
| 1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
| 1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
| 1912352576 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 3880 Rosecrans Street, San Diego, CA 92110 | 2016-05-02 |
| Find all providers in zip 92110 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689204265 | Juvelyn Isip Ingal | Registered Nurse | 3853 Rosecrans St # Ca92110, San Diego, CA 92110-3115 | 2020-01-22 |
| 1043859531 | Klair Grace | Registered Nurse | 6460 Convoy Ct Spc 115, San Diego, CA 92117-2314 | 2019-12-31 |
| 1225509656 | Erwin Orio Fong | Registered Nurse | 3853 Rosecran St, San Diego, CA 92110-3115 | 2018-12-11 |
| 1780139220 | Sarah Sangalang Villanueva | Registered Nurse | 1625 Chalcedony St, 205, San Diego, CA 92109-3169 | 2016-08-24 |
| 1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
| 1063870376 | Matthew O'connor | Registered Nurse | 3417 Front St, San Diego, CA 92103-4813 | 2016-02-01 |
| 1417320599 | Brittany Moore | Registered Nurse | 4335 Hamilton St Apt 6, San Diego, CA 92104-1271 | 2015-11-11 |
| 1174992812 | Farren Kelly Joynes | Registered Nurse | 6713 Waterman Ct, San Diego, CA 92111-6033 | 2015-09-23 |
| 1922476886 | Nichole Jimmi | Registered Nurse | 1670 Kettner Blvd, Apt 122, San Diego, CA 92101-2522 | 2015-09-09 |
| 1700158672 | Vitaly Juravsky | Registered Nurse | 3853 Rosecrans Street San Diego, Ca, San Diego, CA 92110 | 2012-02-07 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.