Provider Demographics
NPI:1669359600
Name:KEATING, MARIELLA (NP)
Entity type:Individual
Prefix:MRS
First Name:MARIELLA
Middle Name:
Last Name:KEATING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18847 KINBRACE ST
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1030
Mailing Address - Country:US
Mailing Address - Phone:818-633-8525
Mailing Address - Fax:
Practice Address - Street 1:18847 KINBRACE ST
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-1030
Practice Address - Country:US
Practice Address - Phone:818-633-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95035281363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care