Keltner, Lisa Valentine

Keltner, Lisa Valentine is an individual health care provider with primary practice located at 4515 Central Ave Ste 101 , Riverside CA 92506-2374. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Low Vision Rehabilitation. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Keltner, Lisa Valentine can be contacted via phone (951) 784-2420.

Contact Information

Primary practice address
4515 Central Ave Ste 101 Riverside CA 92506-2374
Fax: (951) 784-4713
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 721 Arizona
Eye and Vision Services Providers / Optometrist 152W00000X 113376-9934 Utah
Eye and Vision Services Providers / Low Vision Rehabilitation 152WL0500X 08887TLG California
Eye and Vision Services Providers / Optometrist 152W00000X 08887TLG California

Profile Details

NPI number 1629072533
LBN Legal business name Keltner, Lisa Valentine
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Mar 7th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629072533 NPPES
California MEDICAID SD0088870

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