Kelly Anderson, RN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN95245715 Issued in CA

Practice address

13030 Colonial Dr
Rancho Cucamonga, CA 91739-8866

Phone

(310) 367-6963

NPI assigned

May 8, 2024

Sex

Female

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1715126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1295583979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13030 COLONIAL DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917398866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13030 COLONIAL DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917398866",
            "telephone_number": "310-367-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KELLY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-08",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "RN95245715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Rose Anderson
• Cynthia Anderson
• Deborah Anderson
• Desiree Nicole Anderson
• Elisabeth Anderson
• Kendra L Anderson, RBT
• Kristina M Anderson, LMFT
• Lauren Anderson
• Rose Theresa Anderson, R.N., MSN, PMHNP-BC
• Sheldon Troy Anderson, PH.D.

• Adult Psychiatric/Mental Health Registered Nurse in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in California

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