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NPI Code Detail

MEDICARE: ANGELIA KEATON

MEDICARE: ANGELIA KEATON
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1992452684
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELIA KEATON
Provider Business Mailing Address
First Line : 4838 LAUREL CANYON BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91607-3717
Country : US
Telephone Number : 818-506-4455
Fax Number : 818-506-5185
Provider Business Practice Location Address
First Line : 4838 LAUREL CANYON BLVD
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91607-3717
Country : US
Telephone Number : 818-506-4455
Fax Number : 818-506-4455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2022
Last Update Date : 03/03/2022

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Directions to “ ANGELIA KEATON ” Practice Location

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