Kelleen Carrie Stainer

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW29834 Issued in CA

Practice address

555 Anton Blvd Ste 150
Costa Mesa, CA 92626-7036

Phone

(949) 204-0011

NPI assigned

Jan 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1053025858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 ANTON BLVD STE 150",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267036",
            "telephone_number": "949-204-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 ANTON BLVD STE 150",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267036",
            "telephone_number": "949-204-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAINER",
        "first_name": "KELLEEN",
        "middle_name": "CARRIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW29834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Gillis Chiropractic Inc
• Danielle Stadelman, RDN
• Lindsay Wofford Stadler
• Charles Douglas Stafford, LCSW
• Diana Stafford, COUNSELOR
• Lauren Stairs
• Roxanne Stallworth, M.D., M.P.H.
• Stanley Robert Stanbridge, D.C.
• Standup for Kids
• Yola Stanley, M.S., OTR/L

• Clinical Social Worker in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.