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General NPI Number Information
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NPI Number | 1497087209
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Entity Type | Individual
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Provider Name | ALICIA VIESSA KEITH-QUEEN LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1727 MARTIN LUTHER KING JR. PKWY
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City | OAKLAND
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State | CA
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Zip | 94612
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Country | US
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Telephone | 800-829-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 2919 MISSION ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3917
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Country | US
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Telephone | 425-299-0500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT155722
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT122025
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License Number State | CA
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