| Doctor Name: | REYNA KELLER |
| NPI Number: | 1861868002 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADC II |
| License Number: | |
| Business Practice Address: | 828 W Ventura St Suite 250 Fillmore, CA - 930151876 |
| Business Phone Number: | 8055248644 |
| Business Fax Number: | |
| Mailing Address: | 1125 Sparrow Dr, POINT MUGU NAWC |
| State: | CA |
| Postal Code: | 930414221 |
| Phone Number: | 9402327091 |
| Fax Number: | |
| NPI Enumeration Date: | 08/11/2015 |
| NPI Last Update Date: | 08/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |