KEVIN KETSAN


Address: 2414 S. Fairview St., Suite 212, Santa Ana, CA 92704
Phone: 8778307328

KEVIN KETSAN (NPI# 1407248214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407248214
Entity Type Individual
Full Name KEVIN KETSAN
Credential NP
Practice Address 2414 S. Fairview St.
Suite 212
Santa Ana
CA 92704
Mailing Address 3025 Mary Cmn
Santa Ana
CA 92703-3474
Practice Telephone 8778307328
Practice Fax Number 8778307469
Mailing Telephone 8778307328
Mailing Fax Number 8778307469
Enumeration Date 2015-03-03
Last Update Date 2015-03-03
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
95000775 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2414 S. FAIRVIEW ST.
SUITE 212
City SANTA ANA
State CA
Zip Code 92704

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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1588210504 Jennifer Ang Lim-quevedo Nurse Practitioner 18362 Whitney Dr, Santa Ana, CA 92705 2019-08-15
1194116970 Ming-lung Lu Nurse Practitioner 3401 W Sunflower Ave Ste 225, Santa Ana, CA 92704-6948 2015-02-14
1346585122 Marianne Ethel Minor Nurse Practitioner 2457 N Heliotrope Dr, Santa Ana, CA 92706-1618 2012-12-04
1326646365 Jamie Mary Yono Nurse Practitioner 1231 E Dyer Rd, Santa Ana, CA 92705-5606 2020-10-12
1700437522 Georgina Calderon Nurse Practitioner 801 N Tustin Ave, Santa Ana, CA 92705-3612 2019-09-23
1114440393 Melinda Brown Nurse Practitioner 1241 E Dyer Rd Ste 145, Santa Ana, CA 92705-5694 2017-07-19
1578939153 James Agatep Nurse Practitioner 3401 W Sunflower Ave, Suite 250, Santa Ana, CA 92704-6948 2015-08-18
1295119717 Moniquetta Owens Nurse Practitioner 1241 E Dyer Rd, Santa Ana, CA 92705-5611 2015-07-14
1962836833 Janice Xiao La Woods Nurse Practitioner 3401 W Sunflower Ave Ste 250, Santa Ana, CA 92704-6948 2013-08-28
1003180498 Gerardo M De Jesus Nurse Practitioner 550 N Flower St, Santa Ana, CA 92703-2361 2012-03-02
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Competitor

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City SANTA ANA
Zip Code 92704

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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