Provider Demographics
NPI:1558616201
Name:MASSEL, H. KEITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:H. KEITH
Middle Name:
Last Name:MASSEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 STATE ST STE 7-276
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3138
Mailing Address - Country:US
Mailing Address - Phone:661-425-7066
Mailing Address - Fax:805-299-4505
Practice Address - Street 1:23030 LYONS AVE STE 200
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2754
Practice Address - Country:US
Practice Address - Phone:661-425-7066
Practice Address - Fax:805-299-4505
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-25003103K00000X
CAPSY11229103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY11229OtherPSYCHOLOGIST LICENSE