Healthcare Provider Details

I. General information

NPI: 1851006514
Provider Name (Legal Business Name): YESENIA KELLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9225 CARLTON HILLS BLVD STE 4
SANTEE CA
92071-7901
US

IV. Provider business mailing address

976 COOPER PL
SAN DIEGO CA
92102
US

V. Phone/Fax

Practice location:
  • Phone: 619-258-4000
  • Fax:
Mailing address:
  • Phone: 760-972-7135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021160
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: