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NPI Code Detail

MEDICARE: NICHOLE BENKULA KELLER

MEDICARE: NICHOLE BENKULA KELLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker134478CA

General Provider Information

NPI Number : 1295542900
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE BENKULA KELLER
Provider Business Mailing Address
First Line : 2560 W SHAW LN STE 104
Second Line :
City : FRESNO
State : CA
Zip : 93711-2777
Country : US
Telephone Number : 559-443-4800
Fax Number :
Provider Business Practice Location Address
First Line : 2560 W SHAW LN STE 104
Second Line :
City : FRESNO
State : CA
Zip : 93711-2777
Country : US
Telephone Number : 559-443-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2024
Last Update Date : 12/09/2025

Similar Medicare Providers

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1588701353 — SHAVONNE MICHELLE GARIBAY
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1518097898 — J FELIX DUARTE RODRIGUEZ
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Practice Fax:
1528190402 — FRESNO YOUTH ADVOCATES
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Directions to “ NICHOLE BENKULA KELLER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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