Provider Demographics
NPI:1811556749
Name:KELLER, NANCY LEE (LMFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LEE
Last Name:KELLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 WESTWIND DR STE A
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3036
Mailing Address - Country:US
Mailing Address - Phone:661-322-4187
Mailing Address - Fax:661-322-9283
Practice Address - Street 1:2025 WESTWIND DR STE A
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3036
Practice Address - Country:US
Practice Address - Phone:661-322-4187
Practice Address - Fax:661-322-9283
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41369106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist