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Contact Information

KRISTIE KEENEY, SUDRC
1496-1498 NORTH BEALE ROAD
MARYSVILLE, CA95901
 Phone: 530-749-8640
 Fax: 530-749-8646
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for KRISTIE KEENEY · (Female)

NPI Number 1043043128
Status Active
Credentials SUDRC
Entity Individual
Enumeration date 08/23/2024
Last updated 11/18/2025 - About 7 months ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 18064
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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