Provider Demographics
NPI:1871925974
Name:KEITH, ROSEMARY (AMFT)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:KEITH
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-3985
Mailing Address - Country:US
Mailing Address - Phone:408-783-8110
Mailing Address - Fax:408-727-1817
Practice Address - Street 1:2625 ZANKER RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134
Practice Address - Country:US
Practice Address - Phone:408-283-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health