Healthcare Provider Details

I. General information

NPI: 1558800292
Provider Name (Legal Business Name): MARKIE DAMIANA LPC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARKIE KEELAN

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 CAMINO TOLUCA
CAMARILLO CA
93010-2667
US

IV. Provider business mailing address

2108 N ST STE N
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 805-764-1244
  • Fax:
Mailing address:
  • Phone: 805-764-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: