AMANDA KELLER (NPI# 1700373040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700373040 |
| Entity Type | Individual |
| Full Name | AMANDA KELLER |
| Practice Address |
101 Bodin Cir Fairfield CA 94535 |
| Mailing Address |
1443 Chesham Cir Colorado Springs CO 80907-8619 |
| Practice Telephone | 2096488550 |
| Mailing Telephone | 2096488550 |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2020-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TRICARE | UNKNOWN | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538454343 | Amanda Keller | Occupational Therapist | 2000 Baltusrol Ln, Lexington, KY 40509-8494 | 2011-06-09 |
| 1588976336 | Amanda Marie Keller | Optometrist | 7050 Watts Rd, Madison, WI 53719-1365 | 2010-07-09 |
| 1538349535 | Amanda Leigh Keller | Case Manager/Care Coordinator | 7345 Highway 62 West, Gassville, AR 72635 | 2007-11-07 |
| 1487277133 | Amanda Keller | Behavior Technician | 3441 Fort Campbell Blvd Ste F3, Clarksville, TN 37042-6684 | 2020-05-28 |
| 1093375131 | Amanda Keller | Counselor | 1385 King Ave, Columbus, OH 43212-2220 | 2019-06-20 |
| 1154823771 | Amanda Keller | Behavior Technician | 1887 Monterey Hwy Ste 225, San Jose, CA 95112-6117 | 2018-02-28 |
| 1659772101 | Amanda Keller | Counselor | 9754 Kenwood Rd, Blue Ash, OH 45242-6159 | 2014-09-15 |
| 1477991339 | Amanda Keller | Social Worker | 117 S Main St, Suite 2, Freeland, MI 48623-8935 | 2013-06-12 |
| 1336481571 | Amanda Leigh Keller | Social Worker | 2215 Burdett Ave, Troy, NY 12180-2466 | 2013-03-26 |
| 1427317643 | Amanda Marie Keller | Pharmacist | 521 N Fraley St, Kane, PA 16735-1162 | 2012-05-08 |
| Street Address |
101 BODIN CIR |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912504093 | Dallas Mcwilliams | Military Health Care Provider | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-10-02 |
| 1669082897 | Sahra K. Pak | Dietitian, Registered | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-08-03 |
| 1164031407 | Abigail Greenwell | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-07-22 |
| 1851919468 | Derek P Brady | Military Health Care Provider | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-07-09 |
| 1588282396 | Jacob Blotter | Counselor | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-07-08 |
| 1154947679 | Daniel Warren Cline | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-06-20 |
| 1477174654 | Robert Dillon Hill | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-04-29 |
| 1124653878 | Hana L Ha | Pharmacist | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-03-03 |
| 1972137644 | Audrey Nicole Imperial | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-03-02 |
| 1366074163 | Christian Heinrich Kniep | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2020-02-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466493 | Lizbeth Padilla | Student in an Organized Health Care Education/Training Program | 1125 Hayes St, Fairfield, CA 94533-4707 | 2020-08-04 |
| 1003426024 | Rebecca M Dance | Student in an Organized Health Care Education/Training Program | 5752 David Pl, Fairfield, OH 45014-3508 | 2020-08-04 |
| 1942819826 | Lauren J Cotton | Student in an Organized Health Care Education/Training Program | 1073 North Benson Road, Fairfield, CT 06824 | 2020-07-28 |
| 1396368585 | Sadek Debwan | Student in an Organized Health Care Education/Training Program | 2813 Shelter Hill Dr, Fairfield, CA 94534-8628 | 2020-05-21 |
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1023647989 | Maggie Giambalvo | Student in an Organized Health Care Education/Training Program | 752 Towne House Rd, Fairfield, CT 06824-1819 | 2020-04-03 |
| 1518503689 | Greta Jones | Student in an Organized Health Care Education/Training Program | 855 Mcglaughlin Rd, Fairfield, PA 17320-9002 | 2019-11-22 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1427600550 | Nancy Ivette Bocanegra | Student in an Organized Health Care Education/Training Program | 1607 Clay St, Fairfield, CA 94533-3808 | 2019-07-09 |
| 1013481316 | Raquel Marie Divincenzo | Student in an Organized Health Care Education/Training Program | 5151 Park Ave # Mc1425, Fairfield, CT 06825-1090 | 2019-01-20 |
| Find all providers in FAIRFIELD | ||||
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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.