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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

KEEBY TIE
NPI 1902711823
Student in an Organized Health Care Education/Training Program in San Rafael, CA

Active since August 17, 2026
50 ACACIA AVE, SAN RAFAEL, CA 94901(415) 457-4440 Get Directions Write a Review

NPPES record added: August 17, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Keeby Tie NPPES

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

KEEBY TIE (NPI 1902711823) is an individual student in an organized health care education/training program in San Rafael, California and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1902711823
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameKEEBY TIE
Location Address50 ACACIA AVESan Rafael, CA 94901-2230
Mailing Address3307 Martha CirPasadena, CA 91107-5535 · (323) 719-4089
Phone(415) 457-4440
Sole ProprietorNo
Enumeration DateAugust 17, 2026
NPPES CertifiedAugust 16, 2026
✔ NPI 1902711823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
50 ACACIA AVE, San Rafael, CA 94901
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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.

MIGUEL SERRATO ATC OT-C
Physician Assistant
50 ACACIA AVE
SAN RAFAEL, CA 94901
Marin County (415) 457-4440
LAYLA MARY ZEIDAN
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Marin County (415) 457-4440
MICHELLE MOTA
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Marin County (415) 457-4440
THI TRAN PA-C
Physician Assistant
50 ACACIA AVE
SAN RAFAEL, CA 94901
Marin County (415) 457-4440
EMILY GAO
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Marin County (415) 457-4440
TRICIA HO
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Marin County (415) 457-4440
ROLAND JONATHAN CASIQUIN
Student in an Organized Health Care Education/Training Program
50 ACACIA AVE
SAN RAFAEL, CA 94901
Marin County (415) 457-4440
CHANTILAY RUFFIN
Physician Assistant
50 ACACIA AVE, MEADOWLANDS 302
SAN RAFAEL, CA 94901
Marin County (415) 482-3571

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 Keeby Tie's NPI number?

The NPI number for Keeby Tie is 1902711823. It was assigned to this individual provider in the NPPES registry on August 17, 2026.

Where is Keeby Tie located?

Keeby Tie practices at 50 Acacia Ave, San Rafael, CA 94901. The listed phone number is (415) 457-4440.

What is Keeby Tie's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Keeby Tie was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days 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.