Keith Park Valid NPI
Individual provider · Counselor · Calimesa, CA
- NPI
- 1710101092
- Type
- Individual (Type 1)
- Primary specialty
- Counselor
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101Y00000X
- License number
- 0085201 (NM)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2007-04-11
- Last updated
- 2025-09-11
Practice location
908 Park Ave
Calimesa, CA 92320-1148
(909) 518-3886