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NPI Code Detail

MEDICARE: CASSMIER KELLER

MEDICARE: CASSMIER 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
1103T00000XPsychologist

General Provider Information

NPI Number : 1457209827
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSMIER KELLER
Provider Business Mailing Address
First Line : 25745 BARTON RD # 257
Second Line :
City : LOMA LINDA
State : CA
Zip : 92354-3812
Country : US
Telephone Number : 951-237-8998
Fax Number :
Provider Business Practice Location Address
First Line : 301 N LAKE AVE STE 600
Second Line :
City : PASADENA
State : CA
Zip : 91101-5129
Country : US
Telephone Number : 626-354-6440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2026
Last Update Date : 03/20/2026

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Directions to “ CASSMIER KELLER ” Practice Location

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