Keyon Anderson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123826 Issued in CA

Practice address

30 N Raymond Ave Ste 602
Pasadena, CA 91103-4443

Phone

(562) 283-5986

NPI assigned

Aug 28, 2024

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

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": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1992539282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11058 CHANDLER BLVD APT 1009E",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916014176",
            "telephone_number": "562-283-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N RAYMOND AVE STE 602",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911034443",
            "telephone_number": "562-283-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KEYON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "123826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad Charles Anderson, OTR/L
• Deborah Anderson
• Jack Glenn Anderson, PH.D.
• Jenae Corlette Anderson, MPH, RDN
• Karyn Anne Anderson, LMFT
• Kristen Anderson
• Laurie Anderson, PAC
• Mecca Malia Anderson
• Rhanara L Anderson
• Tanya Naomi Andino, M.S.

• Clinical Social Worker in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.