Most Relevant Information
Provider Data
| NPI Number: | 1003340480 |
| Provider Name: | MATTHEW ALLEN KELLER |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 99118 |
Most Important Dates
| Enumeration Date: | 04/12/2017 |
| Last Updated: | 02/13/2019 |
Provider Practice Location
161 W VICTORIA ST
LONG BEACH
CA
90805
Practice Location Phone/Fax
| Phone: | 3232425000 |
| Fax: |
Provider Mailing Location
161 W VICTORIA ST
LONG BEACH
CA
908052175
Provider Mailing Phone/Fax
| Phone: | 3232425000 |
| Fax: |