ANDY BURL KELLEMS II (NPI# 1639556673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639556673 |
| Entity Type | Individual |
| Full Name | ANDY BURL KELLEMS II |
| Credential | CADC |
| Practice Address |
3151 Airway Ave Ste F107 Costa Mesa CA 92626-4623 |
| Mailing Address |
21062 Brookhurst St Ste 201 Huntington Beach CA 92646-7404 |
| Practice Telephone | 7149646730 |
| Practice Fax Number | 7149644382 |
| Mailing Telephone | 7149646730 |
| Mailing Fax Number | 7149644382 |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
081486 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CAADE | 081486 | 01 |
| Street Address |
3151 AIRWAY AVE STE F107 |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-4623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851790968 | Esteban Juarez | Social Worker | 3151 Airway Ave Ste F107, Costa Mesa, CA 92626-4623 | 2014-08-14 |
| 1689156507 | Lead Recovery Transitional Living Center, LLC | Case Management | 3151 Airway Ave Ste F107, Costa Mesa, CA 92626-4623 | 2018-09-06 |
| 1427441674 | Hired Power Transitional Living Center LLC | Substance Abuse Rehabilitation Facility | 3151 Airway Ave Ste F107, Costa Mesa, CA 92626-4623 | 2015-03-12 |
| 1053704569 | Hired Power Transitional Living Center | Clinic/Center | 3151 Airway Ave Ste F107, Costa Mesa, CA 92626-4623 | 2015-03-08 |
| 1285025684 | Hired Power Transitional Living Center, LLC | Case Management | 3151 Airway Ave Ste F107, Costa Mesa, CA 92626-4623 | 2015-02-07 |
| 1750779492 | Arturo Diaz Jr. | Social Worker | 3151 Airway Ave Ste F107, Costa Mesa, CA 92626-4623 | 2015-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407312051 | Joan Marie Franco | Counselor | 2001 Harbor Blvd Ste 200, Costa Mesa, CA 92627-8518 | 2019-02-19 |
| 1699277251 | Leslie Margarita Wilson | Counselor | 2900 Bristol St Ste 103, Costa Mesa, CA 92626-5981 | 2018-02-28 |
| 1003276700 | Claudio Nunez | Counselor | 2165 Harbor Blvd, Costa Mesa, CA 92627-2529 | 2016-02-24 |
| 1437519188 | Marsha Lynn Coxen | Counselor | 2940 Peppertree Ln Apt C, Costa Mesa, CA 92626-3850 | 2016-02-23 |
| 1821331497 | Ashley Rae Richmond | Counselor | 2001 Harbor Blvd, Suite 220, Costa Mesa, CA 92627 | 2013-04-02 |
| 1801150149 | Lynn Talmon | Counselor | 3001 Red Hill Ave. Building 2 Suite 215, Costa Mesa, CA 92627-9262 | 2012-07-02 |
| 1386907418 | Zen Recovery,llc | Counselor | 126 E 16th St, Costa Mesa, CA 92627-7704 | 2012-06-22 |
| 1578826616 | Dawn Forteville | Counselor | 2080 President Pl, Costa Mesa, CA 92627-4014 | 2012-06-22 |
| 1144463001 | Justinna Lang Taing | Counselor | 2300 Fairview Rd Apt P102, Costa Mesa, CA 92626-6483 | 2009-04-08 |
| 1588262380 | Rosario Zatarain | Counselor | 275 Victoria St Ste 1h, Costa Mesa, CA 92627-1906 | 2020-10-14 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on ANDY BURL KELLEMS II.
| 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.