Kenneth Joseph Kaiser, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS13358 Issued in CA

Practice address

585 N Mountain Ave Ste B
Upland, CA 91786-8516

Phone

(909) 702-2068

NPI assigned

Feb 2, 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1984

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Mountain View Behavioral Health IncGroup PAC ID 4385725266, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mountain View Behavioral Health,Inc.

  • Mental Health Counselor
  • Upland, CA
  • NPI 1043391295
  Medicare reassignment Care Compare group NPD Authorized official
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment Care Compare group NPD
• Ashleywilliams Counseling, Inc

  • Community/Behavioral Health Agency
  • Cerritos, CA
  • NPI 1174807408
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1306818653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12420 BAKER AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102303",
            "telephone_number": "909-702-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 N MOUNTAIN AVE STE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868516",
            "telephone_number": "909-702-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISER",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CSW133580",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EPS011090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wyatt James Kaiban
• Penninah M Kaigwa, RN
• Kaiser Foundation Health Plan Inc
• Kaiser Permanente
• Kaiser Permanente Pharmacy
• Robert Flynn Kamansky, D.D.S.
• Vanessa Bryanne Kamchamnan, HCA
• Kitti Kamm
• Sangku Kang, M.D.
• Montra M Kanok, MD

• Clinical Social Worker in Upland, CA
• Providers in Upland, 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 Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.