Kelley Kozlowski

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

4804 Iroquois Ave
San Diego, CA 92117-6248

Phone

(708) 953-3144

NPI assigned

Aug 20, 2018

Sex

Female

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

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1891275707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 IROQUOIS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176248",
            "telephone_number": "708-953-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 IROQUOIS AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176248",
            "telephone_number": "708-953-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOWSKI",
        "first_name": "KELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "XOH846822315",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Koyano, RD
• Casey Kozak, MD
• Kevin Mark Kozakowski, DO
• Eliana L Kozin, BCH BAO
• Mary Lynne Koziorowski, CADC II
• Jade Marie Kozuch, PHARMD
• John Patrick Kozy, MD
• Kpab MD Inc
• Hope Kraatz, RN
• Janine Rae Krachman, NP

• Community/Behavioral Health Agency in San Diego, CA
• Providers in San Diego, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.