Provider Demographics
NPI:1104631431
Name:KEALEY, WILLIAM FREDRICK
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FREDRICK
Last Name:KEALEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 OCEAN AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3559
Mailing Address - Country:US
Mailing Address - Phone:303-905-4725
Mailing Address - Fax:
Practice Address - Street 1:902 MONTEREY SALINAS HWY
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93908-8820
Practice Address - Country:US
Practice Address - Phone:831-293-4492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical