Individual provider Active NPI

Kevin Lee Killian, LMHP

  • Rehabilitation Practitioner
  • San Francisco, CA
National Provider Identifier
1053464933
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
673 San Jose Ave
San Francisco, CA 94110-4914
Phone
(415) 282-3789
Fax
(415) 695-0829
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Primary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 3112 NE

Addresses

Primary practice location

673 San Jose Ave
San Francisco, CA 94110-4914

Mailing address

319 South 17TH Street #240
Omaha, NE 68102
Phone (402) 558-3856

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

State licenses

LicenseStateTypeSpecialty
3112NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baker Place, Inc Past Accepting new patients
Baker Places, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1053464933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 SOUTH 17TH STREET #240",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68102",
            "telephone_number": "402-558-3856",
            "fax_number": "402-558-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 SAN JOSE AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941104914",
            "telephone_number": "415-282-3789",
            "fax_number": "415-695-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "credential": "LMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.