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NPI Code Detail

MEDICARE: SOMMY KEO

MEDICARE: SOMMY KEO
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619554466
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOMMY KEO
Provider Business Mailing Address
First Line : 1401 FULTON ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1643
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1401 FULTON ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1643
Country : US
Telephone Number : 559-348-9225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2021
Last Update Date : 03/26/2021

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Directions to “ SOMMY KEO ” Practice Location

Language Start Address Practice Location
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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