Individual
MS. JENNIFER KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 UNIVERSITY AVE, SUITE # 101, EAST PALO ALTO, CA 94303-2212
(650) 494-1000
(650) 433-5448
Mailing address
1900 UNIVERSITY AVE, SUITE # 101, EAST PALO ALTO, CA 94303-2212
(650) 494-1000
(650) 433-5448
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU 2521
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7477
HEARING AID DEPENSING LICENSE
CA
01
—
AU 2521
STATE AUDIOLOGY LICENSE
CA
Enumeration date
05/04/2009
Last updated
05/04/2009
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