MEDICARE: JOSIE MARLEENA 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
1	374J00000X	Doula

General Provider Information

NPI Number	:	1790623189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSIE MARLEENA KELLER

Provider Business Mailing Address
First Line	:	4421 VICO WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95864-3151
Country	:	US
Telephone Number	:	916-291-6323
Fax Number	:

Provider Business Practice Location Address
First Line	:	4421 VICO WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95864-3151
Country	:	US
Telephone Number	:	916-291-6323
Fax Number	:

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

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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Directions to “ JOSIE MARLEENA KELLER ” Practice Location

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