Kevin Ketsan, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95000775 Issued in CA

Practice address

2414 S. Fairview St.
Suite 212
Santa Ana, CA 92704

Phone

(877) 830-7328

Fax

(877) 830-7469

NPI assigned

Mar 3, 2015

Last updated

Mar 3, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Firstcare Hospice Inc

  • Community Based Hospice Care Agency
  • Huntington Beach, CA
  • NPI 1275913758
  NPD (past)

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1407248214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 MARY CMN",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927033474",
            "telephone_number": "877-830-7328",
            "fax_number": "877-830-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 S. FAIRVIEW ST.",
            "address_2": "SUITE 212",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "877-830-7328",
            "fax_number": "877-830-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETSAN",
        "first_name": "KEVIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95000775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan J Kern
• Kerry K Delk, PHD, Incorporated (Newport Psychology Group)
• Dana Kert, M.A., AMFT 124596
• Jian Yi Kertcher
• William Robert Kessler, D.C.
• Marian Saddi Kettler, LMFT
• Key Medical Rehab Inc.
• Katrina Keyner
• Khaef Professional Dental Corp
• Aya Khalil

• Adult Health Nurse Practitioner in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.