Provider Demographics
NPI:1063231850
Name:KEYLANI, JUDY IMANE
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:IMANE
Last Name:KEYLANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 8TH AVE APT 110
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-3000
Mailing Address - Country:US
Mailing Address - Phone:860-268-0164
Mailing Address - Fax:
Practice Address - Street 1:1605 8TH AVE APT 110
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-3000
Practice Address - Country:US
Practice Address - Phone:860-268-0164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula