Healthcare Provider Details

I. General information

NPI: 1396132460
Provider Name (Legal Business Name): JOCELYN KEEHNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15644 POMERADO RD STE 202
POWAY CA
92064-2434
US

IV. Provider business mailing address

15644 POMERADO RD STE 202
POWAY CA
92064-2434
US

V. Phone/Fax

Practice location:
  • Phone: 858-312-5459
  • Fax: 858-345-3743
Mailing address:
  • Phone: 858-312-5459
  • Fax: 858-345-3743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA160871
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number274128
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA160871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: