Individual
KEITH HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 WILLOW PASS RD STE 100, CONCORD, CA 94520-7946
(925) 348-5439
(925) 646-5774
Mailing address
1430 WILLOW PASS RD STE 100, CONCORD, CA 94520-7946
(925) 348-5439
(925) 646-5774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
CA
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5650646
CA DRIVERS LICENSE
CA
Enumeration date
03/29/2017
Last updated
04/29/2025
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