Individual provider · Type 1 NPI
Keith Park
Counselor · Calimesa, CA
NPI number
1710101092
Active
Practice location
908 Park Ave
Calimesa, CA 92320-1148
Fax (909) 790-9333
Mailing address
PO Box 1526
Yucaipa, CA 92399-1435
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor Primary | 101Y00000X | 0085201 (NM) |
| Psychologist | 103T00000X | PSY 18884 (CA) |
Counselor: 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.
Other counselor providers in Calimesa
About NPI 1710101092
Keith Park's National Provider Identifier is 1710101092, issued on Apr 11, 2007. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Calimesa, CA. The record was last updated on Sep 11, 2025.