Individual provider Active NPI

Keisha Nichole Kasozi

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1740612910
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
104669 Issued in CA
Practice address
333 S. Beaudry Avenue
Los Angeles, CA 90017
Phone
(213) 241-3841
Fax
(213) 241-3305
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 104669 CA Primary

Addresses

Primary practice location

333 S. Beaudry Avenue
Los Angeles, CA 90017

Mailing address

333 S Beaudry Ave
Los Angeles, CA 90017-1466
Phone (213) 241-3841

Other practice location 1

5757 Wilshire Blvd
Los Angeles, CA 90036-5810
Phone (323) 931-6025

Other practice location 2

1533 Euclid St
Santa Monica, CA 90404-3306
Phone (310) 451-9747

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

LicenseStateTypeSpecialty
104669CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1740612910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S BEAUDRY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171466",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S. BEAUDRY AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90017",
            "telephone_number": "213-241-3841",
            "fax_number": "213-241-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5757 Wilshire Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900365810",
            "country_code": "US",
            "telephone_number": "323-931-6025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1533 Euclid St",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904043306",
            "country_code": "US",
            "telephone_number": "310-451-9747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASOZI",
        "first_name": "KEISHA",
        "middle_name": "NICHOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "104669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.