Active NPI
Mandy Keovilay
- Clinical Social Worker
- Visalia, CA
National Provider Identifier
1316651946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 120245
- Practice address
- 530 Kings County Dr
Visalia, CA 93290 - Phone
- (559) 754-4847
- NPI assigned
- Jan 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 120245 | CA | Primary |
Addresses
Primary practice location
530 Kings County Dr
Visalia, CA 93290
Mailing address
530 Kings County Dr
Hanford, CA 93230-3579
Phone (559) 410-1815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120245 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724889600000",
"number": "1316651946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 KINGS COUNTY DR",
"city": "HANFORD",
"state": "CA",
"postal_code": "932303579",
"telephone_number": "559-410-1815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 KINGS COUNTY DR",
"city": "VISALIA",
"state": "CA",
"postal_code": "93290",
"telephone_number": "559-754-4847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOVILAY",
"first_name": "MANDY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-09",
"last_updated": "2024-08-29",
"certification_date": "2024-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "120245",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Visalia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.