Kennedy Otieno Oyalo

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

11745797 Issued in AZ

Practice address

9858 E Hay Loft Dr
Florence, AZ 85132-7369

Phone

(480) 578-3995

NPI assigned

Jun 19, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1457036337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9858 E HAY LOFT DR",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851327369",
            "telephone_number": "480-578-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9858 E HAY LOFT DR",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851327369",
            "telephone_number": "480-578-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OYALO",
        "first_name": "KENNEDY",
        "middle_name": "OTIENO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "11745797",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "11745797",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Thomas O'Steen, M.D.
• Cynthia Obaigwa
• Erin Olney, RBT
• Garrick Andrew Olsen, PA-C
• Charity Felicia Olson, PHARMD
• Blain Alan Packard
• Susan Packer, FNP-C
• Sophia Grace Paffumi
• Amy Nicole Peacock, FNP-C
• Ke'Alohilani M Pedro

• Community/Behavioral Health Agency in Florence, AZ
• Providers in Florence, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.