Individual provider Active NPI

Keenan Ejay Toussaint

  • Community Health Worker
  • San Francisco, CA
National Provider Identifier
1386260214
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1405 Guerrero St
San Francisco, CA 94110-4324
Phone
(415) 861-0828
Fax
(415) 861-0140
NPI assigned
Jun 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Primary

Addresses

Primary practice location

1405 Guerrero St
San Francisco, CA 94110-4324

Mailing address

368 Fell St
San Francisco, CA 94102-5144
Phone (415) 861-0828

Other practice location 1

368 Fell St
San Francisco, CA 94102-5144
Phone (415) 861-0828 ext. 132

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

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1386260214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 FELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941025144",
            "telephone_number": "415-861-0828",
            "fax_number": "415-861-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 GUERRERO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941104324",
            "telephone_number": "415-861-0828",
            "fax_number": "415-861-0140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "368 Fell St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941025144",
            "country_code": "US",
            "telephone_number": "415-861-0828 x132",
            "fax_number": "415-861-0140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOUSSAINT",
        "first_name": "KEENAN",
        "middle_name": "EJAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.