Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Neal Dexter Ketchum

Individual provider Registered Nurse · NPI 1225770670

Neal Dexter Ketchum is a Certified Registered Nurse Anesthetist (CRNA) in San Francisco, California. Qualified in 2022, 4 years ago. Practices with San Joaquin Faculty Medical Group, a 129-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
4
Licensed in
CA
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

500 Parnassus Ave
San Francisco, CA 94143-2203
Phone: (415) 883-0944
Fax: (415) 476-9516
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 101 Bodin Cir, Fairfield, CA 94535-1809 — (707) 423-3490

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 95001818 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 826887 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1225770670
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 7, 2022
Last updated in NPPESNovember 29, 2024
Certification dateNovember 29, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice San Joaquin Faculty Medical Group — 129 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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