Provider Demographics
NPI:1770125726
Name:KEIFE, TRINITY ANN
Entity type:Individual
Prefix:
First Name:TRINITY
Middle Name:ANN
Last Name:KEIFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17764 EUCALYPTUS ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-5153
Mailing Address - Country:US
Mailing Address - Phone:760-264-6882
Mailing Address - Fax:
Practice Address - Street 1:17764 EUCALYPTUS ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-5153
Practice Address - Country:US
Practice Address - Phone:760-264-6882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider