Keisuke Mizuno, BSN, RN

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

99 Pasadena Ave Ste 10C
South Pasadena, CA 91030-6142

Phone

(619) 275-4525

NPI assigned

Apr 28, 2023

Sex

Male

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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1821786674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 PASADENA AVE STE 10C",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910306142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 PASADENA AVE STE 10C",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910306142",
            "telephone_number": "619-275-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZUNO",
        "first_name": "KEISUKE",
        "credential": "BSN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-28",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN95468505",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Sofia Miranda Ramirez
• Mitchell C Latter M D Inc a Prof Corp
• Mitchell C Latter MD Inc a Prof Corp
• Jacinda Mitchell, LMFT
• Roy Isamu Miyashiro, PHARM D
• Davisha Moaning
• Heather Mommaerts
• Jacqueline Monteon
• Aracely Montes
• Kimberly Nathalie Montes

• Behavior Technician in South Pasadena, CA
• Providers in South Pasadena, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.