John W McKean, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

A18205 Issued in CA

Practice address

4411 Levert Ave
Diamond Springs, CA 95619-9738

Phone

(530) 626-5018

Fax

(530) 626-1791

NPI assigned

Jul 26, 2006

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215951017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 LEVERT AVE",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199738",
            "telephone_number": "530-626-5018",
            "fax_number": "530-626-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 LEVERT AVE",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199738",
            "telephone_number": "530-626-5018",
            "fax_number": "530-626-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEAN",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A18205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nora Mae Mays
• Carol Ann McCrory, M.A.
• Ashley Christine McCulloch
• Jessica L McGimsey
• Teresa McIntyre-Harlow, PHD
• Kimberly Michele McKinstry, PT
• Suzanne McLoed
• Jennifer Lynn Mercurio
• Rachel Anne Montiel, LMFT 106066
• Cassandra Moore

• Child & Adolescent Psychiatry Physician in Diamond Springs, CA
• Providers in Diamond Springs, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.