Kelly Saeteurn

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

104877 Issued in CA

Practice address

2744 E 11TH St
Oakland, CA 94601-1440

Phone

(510) 829-2381

NPI assigned

May 4, 2017

Reactivated

Jun 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1134655566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2967 MADELINE ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946023345",
            "telephone_number": "510-570-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 E 11TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946011440",
            "telephone_number": "510-829-2381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 San Leandro Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945771675",
            "country_code": "US",
            "telephone_number": "510-677-0598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAETEURN",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-04",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-25",
        "deactivation_date": "2018-09-14",
        "reactivation_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "104877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meuy Saeparn, RDA
• Erica Saephan
• Mey Siow Saephan, LMFT
• Muang Choy Saephan, MSW
• Joanna Saeteurn
• Kent Saeteurn, B.A.
• Yien Saeteurn
• Chai Saeturn
• Janelle Safdari-Villegas
• Safe Passages

• Student in an Organized Health Care Education/Training Program in Oakland, CA
• Providers in Oakland, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.