Kerry Anne Paysen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW94230 Issued in CA

Practice address

2940 Inland Empire Blvd
Ontario, CA 91764-4898

Phone

(909) 458-1517

NPI assigned

Apr 14, 2014

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1285053652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 INLAND EMPIRE BLVD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917642107",
            "telephone_number": "909-458-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 INLAND EMPIRE BLVD",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917644898",
            "telephone_number": "909-458-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYSEN",
        "first_name": "KERRY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW94230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Lashley Paylor, MS, LPC
• Daijon Payne
• Destyn Payne
• Glenn Joseph Payne, CRT
• Natasha Payne
• Hector Paz Jr
• Sarah Pazmino
• Hayley R Peck, BCBA
• Andrea Pedral Hernandez
• Julian Pedregon

• Clinical Social Worker in Ontario, CA
• Providers in Ontario, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.