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MARY JACQUELINE KELLERMAN CCJP
NPI 1205190451
Counselor - Addiction (Substance Use Disorder) in Tarzana, CA

Active since July 02, 2012
18646 OXNARD ST, TARZANA, CA 91356(818) 996-1051 Get Directions Write a Review

NPPES record last updated: May 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mary Jacqueline Kellerman Ccjp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY JACQUELINE KELLERMAN CCJP (NPI 1205190451) is an individual addiction (substance use disorder) provider in Tarzana, California, licensed in California (CJP980109) and active in the NPI registry since July 2012.

NPPES Registry Identity

NPI1205190451
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMARY JACQUELINE KELLERMANCredential: CCJP
Location Address18646 OXNARD STTarzana, CA 91356-1411
Mailing Address18646 Oxnard StTarzana, CA 91356-1411 · (818) 996-1051
Phone(818) 996-1051
Sole ProprietorYes
Enumeration DateJuly 2, 2012
Last NPPES UpdateMay 17, 2024
NPPES CertifiedMay 17, 2024
✔ NPI 1205190451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · CJP980109
18646 OXNARD ST, Tarzana, CA 91356
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEANNA KATHERINE MALEC RN
Registered Nurse (Case Management)
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (818) 996-1051
NICOLE MARIAN JOHNSTONE RADT
Counselor (Addiction (Substance Use Disorder))
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (818) 654-3950
ARTURO VARGAS
Peer Specialist
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (818) 996-1051
DAVID JEROME FISCHER
Peer Specialist
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (818) 996-1051
HILDA LOPEZ
Case Manager/Care Coordinator
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (818) 654-3850
GREGORY PAUL WALSH
Counselor (Addiction (Substance Use Disorder))
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (818) 996-1051
DAVID HEISERMAN
Counselor (Addiction (Substance Use Disorder))
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (747) 224-0384
JOSHUA KELLY
Student in an Organized Health Care Education/Training Program
18646 OXNARD ST
TARZANA, CA 91356
Los Angeles County (859) 779-2349

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Kellerman's NPI number?

The NPI number for Mary Kellerman is 1205190451. It was assigned to this individual provider in the NPPES registry on July 2, 2012.

Where is Mary Kellerman located?

Mary Kellerman practices at 18646 Oxnard St, Tarzana, CA 91356. The listed phone number is (818) 996-1051.

What is Mary Kellerman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mary Kellerman was last updated on May 17, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.