Keller, Earlene A
Keller, Earlene A is an sole proprietor health care provider with primary practice located at 101 S Forest Rd , Sonora CA 95370. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Keller, Earlene A can be contacted via phone (209) 532-8517.Contact Information
Primary practice address
101 S Forest Rd
Sonora CA 95370
Phone: (209) 532-8517
Fax: (209) 532-3929
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCS14388 | California |
Profile Details
| NPI number | 1306954599 |
|---|---|
| LBN Legal business name | Keller, Earlene A |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 28th, 2006 |
| Last updated | Mar 2nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306954599 | NPPES |
| California | MEDICAID | CSW143880 |
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