Healthcare Provider Details

I. General information

NPI: 1801737671
Provider Name (Legal Business Name): KRISTINE KELLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE
SAN FRANCISCO CA
94143-2204
US

IV. Provider business mailing address

208 SAN JOSE AVE
SAN FRANCISCO CA
94110-3721
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75139
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: