Keierra Anderson

Key facts

NPI

1083170955

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Technician 106S00000X

Practice address

206 N Jackson St Ste 202
Glendale, CA 91206-4330

Phone

(855) 295-3276

NPI assigned

Feb 15, 2019

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 15, 2019.

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1083170955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N JACKSON ST STE 202",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N JACKSON ST STE 202",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064330",
            "telephone_number": "855-295-3276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KEIERRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

• Heather Marie Andersen, MPT
• Anthony K Anderson, MD
• Calista Anderson, LMFT
• Jill Page Anderson, LCSW
• Jill Suzanne Anderson, LMFT
• Matthew Ian Anderson, LAC
• Michelle Anderson
• Leo Andonian
• Andre Eliasian Dental Corporation
• Andre F. Henry Medical Enterprise Inc.

All providers in Glendale, CA · Behavior Technician in California