Keisha Whitehurst

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

165 W Hospitality LN Ste 11
San Bernardino, CA 92408-3322

Phone

(866) 664-0426

NPI assigned

Oct 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1319155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1760768790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 W HOSPITALITY LN STE 11",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 W HOSPITALITY LN STE 11",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083322",
            "telephone_number": "866-664-0426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1260 E Arrow Hwy",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864982",
            "country_code": "US",
            "telephone_number": "909-932-1069",
            "fax_number": "909-579-0243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6154 Mission Gorge Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921203435",
            "country_code": "US",
            "telephone_number": "619-285-1718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEHURST",
        "first_name": "KEISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-21",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmin K White, CADC-1
• Json McKinzee-Peterson White
• Vanswan White
• Wilda O White
• William Beckwith White, D.D.S.
• Kimberli Patriece Whitman, M.A., MFT
• Whitney Young Family Health Clinic
• Amada Sukumu Whitson, MSW, ASW
• Ashlyn Whittaker
• Daron Lamar Whitworth

• Addiction (Substance Use Disorder) Counselor in San Bernardino, CA
• Providers in San Bernardino, 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 Oct 15, 2025; 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.