Lance Aaron Kennedy

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Practice address

18811 Redwing St
Tarzana, CA 91356-3341

Phone

(240) 205-9462

NPI assigned

Jun 25, 2024

Sex

Male

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

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1104661925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18811 REDWING ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563341",
            "telephone_number": "240-205-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18811 REDWING ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563341",
            "telephone_number": "240-205-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LANCE",
        "middle_name": "AARON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Kazmi, RADT-1
• Adelle Kelleher
• Mary Jacqueline Kellerman, CCJP
• Constance Kellogg, PH.D.
• Joshua Kelly
• Chanel Gold Kenner
• Kenneth Kleinman M.D., Inc.
• Ani Keshishyan, BCBA
• Katrina Ketterer, BCBA
• Kevin J. Pelton MD, Inc.

• Substance Abuse Rehabilitation Facility in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.