Provider Demographics
NPI:1679718142
Name:KELLER, BARBARA MOSS (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:MOSS
Last Name:KELLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-2928
Mailing Address - Country:US
Mailing Address - Phone:650-888-2290
Mailing Address - Fax:
Practice Address - Street 1:660 MIDDLEFIELD RD # B
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2125
Practice Address - Country:US
Practice Address - Phone:650-888-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical