KENNETH EATMON (NPI# 1548686124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548686124 |
| Entity Type | Individual |
| Full Name | KENNETH EATMON |
| Credential | LLP |
| Practice Address |
617 S Olive St Ste 200 Los Angeles CA 90014-1646 |
| Practice Telephone | 2134309080 |
| Mailing Telephone | 3129331459 |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2018-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TF0200X |
Psychologist Specialization: Forensic |
6301014325 | MI | Behavioral Health & Social Service Providers |
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1201 W Mission Rd Apt 53, Alhambra, CA 918031707 | (312) 933-1459 |
| Street Address |
617 S OLIVE ST STE 200 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90014-1646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881838936 | Ryan Janis | Psychologist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2009-04-20 |
| 1710505094 | Pandora Kastanis | Student in an Organized Health Care Education/Training Program | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2020-07-13 |
| 1841843331 | Nicole Leah Guzofsky | Marriage & Family Therapist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2019-07-23 |
| 1053964858 | Kimberly Erin Cox | Marriage & Family Therapist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2019-07-20 |
| 1801352927 | Morgan Bogad | Marriage & Family Therapist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2019-02-13 |
| 1396258059 | L & D Psychological Associates, A Professional Corporation | Psychologist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2017-11-15 |
| 1285147884 | Samantha Lauren Chaikin | Marriage & Family Therapist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2017-11-06 |
| 1407386717 | Dylan Paul Ramos | Psychologist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2017-06-19 |
| 1487102570 | Ryan Janis Psyd Inc | Psychologist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2016-09-16 |
| 1194159731 | Lindsay Seong Kramer | Psychologist | 617 S Olive St Ste 200, Los Angeles, CA 90014-1646 | 2013-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992269757 | Los Angeles Christian Health Centers | Clinic/Center | 325 7th Street, Los Angeles, CA 90014 | 2019-01-25 |
| 1770947525 | Dr Jeremy Martinez Md A Professional Corporation | Clinic/Center | 631-a Maple Avenue, Los Angeles, CA 90014 | 2016-04-07 |
| 1578924536 | Jane Shomof | Marriage & Family Therapist | 724 S Spring St #1102, Elements Therapy, Los Angeles, CA 90014 | 2016-03-17 |
| 1588069769 | Los Angeles County Department of Mental Health | Clinic/Center | 631-c Maple Ave, Los Angeles, CA 90014 | 2014-10-29 |
| 1720499619 | County of Los Angeles | Clinic/Center | 242 East 6th Street, Los Angeles, CA 90014 | 2014-05-13 |
| 1235562703 | Savonn Tep | Counselor | 631 Maple Ave Ste C, Los Angeles, CA 90014 | 2013-08-19 |
| 1760759161 | Alice Winther | Psychologist | 617 S. Olive St., Suite 510, Los Angeles, CA 90014 | 2011-11-30 |
| 1265723068 | Shemetra Lachell James | Student in an Organized Health Care Education/Training Program | 617 S. Olive St. Suite #806, Los Angeles, CA 90014 | 2011-04-27 |
| 1558533646 | Leland Scott Frazier | Psychologist | 617 S Olive St, Suite 510, Los Angeles, CA 90014 | 2008-03-28 |
| 1285846287 | United Paratransit | Non-emergency Medical Transport (VAN) | 728 S Hill St, Ste 100, Los Angeles, CA 90014 | 2007-05-04 |
| Find all providers in zip 90014 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020657 | Corinne Elizabeth Zachry | Student in an Organized Health Care Education/Training Program | 1149 S Hill St # H375, Los Angeles, CA 90015-2212 | 2020-10-15 |
| 1750989588 | Jasmine Carpenter | Student in an Organized Health Care Education/Training Program | 4920 S Avalon Blvd, Los Angeles, CA 90011-4004 | 2020-10-14 |
| 1801401062 | Rachel Brenner | Student in an Organized Health Care Education/Training Program | 3787 S Vermont Ave Apt 2, Los Angeles, CA 90007-4203 | 2020-09-14 |
| 1326653593 | Lamia Binhuwaishel | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd, Craniofacial and Special Needs Ortho, Los Angeles, CA 90027 | 2020-09-14 |
| 1154936565 | Samrah Shaheer Abbasi | Student in an Organized Health Care Education/Training Program | 3022 Oakhurst Ave, Los Angeles, CA 90034-2856 | 2020-09-11 |
| 1568077071 | Amber Mottola | Student in an Organized Health Care Education/Training Program | 550 N Figueroa St Apt 4084, Los Angeles, CA 90012-3389 | 2020-09-11 |
| 1760096937 | Elizabeth Idema | Student in an Organized Health Care Education/Training Program | 1559 N Commonwealth Ave, Los Angeles, CA 90027-5513 | 2020-09-03 |
| 1053924225 | Deanna Sharon Lin | Student in an Organized Health Care Education/Training Program | 520 So Lafayette Park Place, 3rd Floor, Los Angeles, CA 90057-5400 | 2020-08-28 |
| 1003429762 | Kendra Knudsen | Student in an Organized Health Care Education/Training Program | 611 Levering Ave Apt 3, Los Angeles, CA 90024-2325 | 2020-08-24 |
| 1750993515 | Deena Basilious | Student in an Organized Health Care Education/Training Program | 1403 S Union Ave, Los Angeles, CA 90015-3205 | 2020-08-21 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90014 |
Please comment or provide details below to improve the information on KENNETH EATMON.
| 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.