KEITH WILLIAM TOM
NPI 1104578897
Counselor - Mental Health in Truckee, CA
Active since January 24, 2022
About Keith William Tom NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEITH WILLIAM TOM (NPI 1104578897) is an individual mental health provider in Truckee, California and active in the NPI registry since January 2022.
NPPES Registry Identity
NPI1104578897
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameKEITH WILLIAM TOM
Location Address10038 MEADOW WAY UNIT DTruckee, CA 96161-4974
Mailing Address2604 Armstrong AveSouth Lake Tahoe, CA 96150-2941 · (510) 381-3705
Phone(510) 381-3705
Sole ProprietorNo
Enumeration DateJanuary 24, 2022
NPPES CertifiedJanuary 24, 2022
✔ NPI 1104578897 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
10038 MEADOW WAY UNIT D, Truckee, CA 96161
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104578897, enumerated as an "individual" on January 24, 2022.
The provider is located at 10038 MEADOW WAY UNIT D TRUCKEE, CA 96161 and the phone number is (510) 381-3705.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.