Healthcare Provider Details

I. General information

NPI: 1073386447
Provider Name (Legal Business Name): KEYMARA CAROLYN STRICKLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S INDIAN HILL BLVD
CLAREMONT CA
91711-5444
US

IV. Provider business mailing address

650 S INDIAN HILL BLVD
CLAREMONT CA
91711-5444
US

V. Phone/Fax

Practice location:
  • Phone: 909-399-2222
  • Fax:
Mailing address:
  • Phone: 909-399-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number286745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: