Healthcare Provider Details

I. General information

NPI: 1386561629
Provider Name (Legal Business Name): KEYS 2 LIFE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 BERRY RD
ROYAL OAKS CA
95076-5606
US

IV. Provider business mailing address

PO BOX 186
WATSONVILLE CA
95077-0186
US

V. Phone/Fax

Practice location:
  • Phone: 831-288-1314
  • Fax:
Mailing address:
  • Phone: 831-288-1314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DANIEL EZEKIEL CONTRERAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 831-406-9291