Active NPI
Kenneth Claude Dunham Jr., PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Monterey, CA
National Provider Identifier
1073008405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 201803763NP-PP
- Practice address
- 473 Cabrillo St BLDG 422
Monterey, CA 93944-3201 - Phone
- (510) 551-8225
- NPI assigned
- Jun 27, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 201803763NP-PP | OR | Primary |
Addresses
Primary practice location
473 Cabrillo St BLDG 422
Monterey, CA 93944-3201
Mailing address
473 Cabrillo St BLDG 422
Monterey, CA 93944-3201
Phone (510) 551-8225
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201803763NP-PP | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712707200000",
"number": "1073008405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "473 CABRILLO ST BLDG 422",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939443201",
"telephone_number": "510-551-8225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "473 CABRILLO ST BLDG 422",
"city": "MONTEREY",
"state": "CA",
"postal_code": "939443201",
"telephone_number": "510-551-8225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "KENNETH",
"middle_name": "CLAUDE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-27",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OR",
"license": "201803763NP-PP",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monterey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.