Keenan Blake Withers

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A193293 Issued in CA

Practice address

5419 W Sunset Blvd
Los Angeles, CA 90027-5691

Phone

(323) 769-6100

NPI assigned

Mar 28, 2021

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The People Concern

  • Community/Behavioral Health Agency
  • Santa Monica, CA
  • NPI 1306977459
  NPD
• The People Concern

  • Community/Behavioral Health Agency
  • Santa Monica, CA
  • NPI 1376800722
  NPD
• The People Concern

  • Community/Behavioral Health Agency
  • Santa Monica, CA
  • NPI 1376811992
  NPD

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1093392615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ STE 37-384",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275691",
            "telephone_number": "323-769-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8484 Wilshire Blvd Ste 750",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902113216",
            "country_code": "US",
            "telephone_number": "310-912-7381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "KEENAN",
        "middle_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A193293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald A Wiss, M.D.
• Adam Wiswell, PSY.D.
• With Love From Mom International
• Debra H Withem, CRNA
• Gordon Withers, MD
• Crystal Witherspoon
• Nykea Witherspoon
• Zoe Witherspoon
• Mallory Withiam
• Withyou Acupuncture & Wellness Center Inc

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.