MEDICARE: KESHON I BUTLER

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
1	175T00000X	Peer Specialist		CA

General Provider Information

NPI Number	:	1689525529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KESHON I BUTLER

Provider Business Mailing Address
First Line	:	2632 ALMADEN ST
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-0877
Country	:	US
Telephone Number	:	559-882-7354
Fax Number	:	559-882-7354

Provider Business Practice Location Address
First Line	:	1223 S LOVERS LANE
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-0877
Country	:	US
Telephone Number	:	559-931-1001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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Directions to “ KESHON I BUTLER ” Practice Location

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