Provider Demographics
NPI:1720967300
Name:NESS, KEEGAN JACOB GARMA (DPT)
Entity type:Individual
Prefix:
First Name:KEEGAN
Middle Name:JACOB GARMA
Last Name:NESS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1088 PROVENCE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-6603
Mailing Address - Country:US
Mailing Address - Phone:916-969-6334
Mailing Address - Fax:
Practice Address - Street 1:10015 FOOTHILLS BLVD # 130
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-7101
Practice Address - Country:US
Practice Address - Phone:916-905-6378
Practice Address - Fax:916-672-0114
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA308574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist