=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528339348
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KEILA FINKLEA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2012
-----------------------------------------------------
Last Update Date | 09/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 W HOSPITAL RD
-----------------------------------------------------
City | FRENCH CAMP
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95231-9693
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-468-6857
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 W HOSPITAL RD
-----------------------------------------------------
City | FRENCH CAMP
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95231-9693
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-468-6857
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 87915
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------