KEVIN KETSAN (NPI# 1407248214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
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 |
Street Address |
2414 S. FAIRVIEW ST. SUITE 212 |
City | SANTA ANA |
State | CA |
Zip Code | 92704 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437771805 | Mohammad Abul-fielat Dds Inc | Dentist | 2341 S Bristol Street, Santa Ana, CA 92704 | 2020-05-08 |
1639728538 | Dorothy A Powell | Technician | 722 S. Arapaho Dr, Santa Ana, CA 92704 | 2019-09-04 |
1851945646 | Skinzone Medical Inc | Plastic Surgery | 3374 S. Bristol St, Santa Ana, CA 92704 | 2019-07-30 |
1215414024 | Sonia Molina | Dietitian, Registered | 2100 W Alton Ave Ste 2, Santa Ana, CA 92704 | 2018-07-24 |
1558854612 | Laura Fessler | Nurse Practitioner | 3501 S. Harbor Blvd, Santa Ana, CA 92704 | 2018-06-12 |
1104317940 | The Mend of California, LLC | Substance Abuse Rehabilitation Facility | 1909 W. Carlton Place, Santa Ana, CA 92704 | 2018-05-29 |
1154811784 | Phleetbo LLC | In Home Supportive Care | 3760 W Mcfadden Ave # B164, Santa Ana, CA 92704 | 2018-05-18 |
1588151393 | United Medical Imaging Healthcare, Inc. | Clinic/Center | 3501 S Harbor Blvd Ste 140-b, Santa Ana, CA 92704 | 2018-04-17 |
1952811978 | Rising Roads Recovery Services for Women, LLC | Substance Abuse Rehabilitation Facility | 2750 S Harbor Blvd Ste G, Santa Ana, CA 92704 | 2017-10-04 |
1427577907 | Advance Oc Surgical Inc. | Clinic/Center | 3500 S. Bristol St., Suite 200, Santa Ana, CA 92704 | 2017-09-15 |
Find all providers in zip 92704 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
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 |
Find all providers in SANTA ANA |
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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.