Pratt, Keith Alan

Pratt, Keith Alan is an individual health care provider with primary practice located at 3340 Kemper St Suite 105, San Diego CA 92110-4906. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Pratt, Keith Alan can be contacted via phone (619) 523-8121.

Contact Information

Primary practice address
3340 Kemper St Suite 105 San Diego CA 92110-4906
Phone: (619) 523-8121
Fax: (619) 523-8742
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1104162684
LBN Legal business name Pratt, Keith Alan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2013
Last updated Jan 2nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104162684 NPPES
California MEDICAID 373781

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