Andy Burl Kellems II, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

081486 Issued in CA

Practice address

3151 Airway Ave Ste F107
Costa Mesa, CA 92626-4623

Phone

(714) 964-6730

Fax

(714) 964-4382

NPI assigned

Apr 29, 2015

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 1

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1639556673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21062 BROOKHURST ST STE 201",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926467404",
            "telephone_number": "714-964-6730",
            "fax_number": "714-964-4382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE F107",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264623",
            "telephone_number": "714-964-6730",
            "fax_number": "714-964-4382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEMS",
        "first_name": "ANDY",
        "middle_name": "BURL",
        "name_suffix": "II",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "081486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAADE",
            "identifier": "081486",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yung Kee, M.D.
• Pamela Keeler
• Nelae Jontue Keene, PA-C
• Lou-Anne Keith, NP
• Virginia Kell
• Tayla Kelley
• Consuelo Alicia Kellogg
• Kelly K McCann MD Inc
• Brittany Lynne Kelly, LCSW
• Courtney Kelly

• Addiction (Substance Use Disorder) Counselor in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.