Dana Monroe Kelley

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

31772 Casino Dr
Lake Elsinore, CA 92530-4502

Phone

(951) 674-9400

NPI assigned

Aug 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dana Monroe Dye Kelley Other name

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1174298624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31772 CASINO DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304502",
            "telephone_number": "951-674-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31772 CASINO DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304502",
            "telephone_number": "951-674-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "DANA",
        "middle_name": "MONROE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "DYE KELLEY",
            "middle_name": "MONROE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anthony Kangethe
• Samson Kiarie Kangiri
• Katy Chou D D S Dental Corp
• Susan Marie Kell, PSY.D.
• Alyssa Michelle Kelley
• Judy Kelly
• Whiskey Kelsey
• Deanna Elizabeth Kennedy, MCPSS
• Jessica Kennedy
• Shalin Kent

• Peer Specialist in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Peer Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.