DR. KEITH PARK
NPI 1710101092
Counselor in Calimesa, CA
NPI Status: Active since April 11, 2007
Contact Information
908 PARK AVE
CALIMESA, CA
ZIP 92320
Phone: (909) 518-3886
Fax: (909) 790-9333
- Individual
- Male
- Counselor
About KEITH PARK
This page provides the complete NPI Profile along with additional information for Keith Park, a provider established in Calimesa, California with a medical specialization in Counselor. The healthcare provider is registered in the NPI registry with number 1710101092 assigned on April 2007. The practitioner's primary taxonomy code is 101Y00000X with license number 0085201 (NM). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1710101092
- Provider Name
- DR. KEITH PARK
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 908 PARK AVE CALIMESA, CA 92320
- Location Phone
- (909) 518-3886
- Location Fax
- (909) 790-9333
- Mailing Address
- PO BOX 1526 YUCAIPA, CA 92399
- Mailing Phone
- (909) 518-3886
- Mailing Fax
- (909) 790-9333
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-11-2007
- Last Update Date
- 09-11-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor
- Taxonomy Code
- 101Y00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 0085201
- License State
- NM
- Taxonomy Description
- A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | PSY 18884 (CA) |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710101092, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710101092, enumerated as an "individual" on April 11, 2007.
The provider is located at 908 PARK AVE CALIMESA, CA 92320 and the phone number is (909) 518-3886.
Counselor with taxonomy code 101Y00000X.
