DR. KEITH PARK
NPI 1710101092
Counselor in Calimesa, CA

Q: What is Keith Park's NPI number?

The NPI number for Keith Park is 1710101092. It was assigned to this individual provider in the NPPES registry on April 11, 2007.

Q: What is Keith Park's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Keith Park was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.

Active since April 11, 2007

908 PARK AVE, CALIMESA, CA 92320(909) 518-3886(909) 790-9333 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Keith Park NPPES

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

DR. KEITH PARK (NPI 1710101092) is an individual counselor in Calimesa, California, licensed in New Mexico (0085201) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1710101092

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameDR. KEITH PARK

Location Address908 PARK AVECalimesa, CA 92320-1148

Mailing AddressPo Box 1526Yucaipa, CA 92399-1435 · (909) 518-3886 · Fax (909) 790-9333

Phone(909) 518-3886

Fax(909) 790-9333

Sole ProprietorYes

Enumeration DateApril 11, 2007

Last NPPES UpdateSeptember 11, 2025

✔ NPI 1710101092 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in NM · 0085201

Definition

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.

Also ListedPsychologistTaxonomy 103T00000X · License PSY 18884 (CA)

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 Keith Park's NPI number?

The NPI number for Keith Park is 1710101092. It was assigned to this individual provider in the NPPES registry on April 11, 2007.

Where is Keith Park located?

Keith Park practices at 908 Park Ave, Calimesa, CA 92320. The listed phone number is (909) 518-3886.

What is Keith Park's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Keith Park was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.