Individual provider Active NPI

Katherine Sue Kelso, BCBA

  • Behavior Analyst
  • South Pasadena, CA
National Provider Identifier
1023441417
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-13441 Issued in CA
Practice address
625 Fair Oaks Ave Ste 200
South Pasadena, CA 91030-2694
Phone
(323) 422-8685
NPI assigned
Aug 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-13441 CA Primary

Addresses

Primary practice location

625 Fair Oaks Ave Ste 200
South Pasadena, CA 91030-2694

Mailing address

7125 Lennox Ave Apt 255
Van Nuys, CA 91405-3141
Phone (818) 720-5838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1023441417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7125 LENNOX AVE APT 255",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053141",
            "telephone_number": "818-720-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 FAIR OAKS AVE STE 200",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302694",
            "telephone_number": "323-422-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "KATHERINE",
        "middle_name": "SUE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-13-13441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.