Healthcare Provider Details
I. General information
NPI: 1427991082
Provider Name (Legal Business Name): KOUESSEU AND ASSOCIATES.INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/09/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2864 E FLORENCE AVE STE 101&102
HUNTINGTON PARK CA
90255-5749
US
IV. Provider business mailing address
2864 E FLORENCE AVE STE 101&102
HUNTINGTON PARK CA
90255-5749
US
V. Phone/Fax
- Phone: 424-376-7211
- Fax:
- Phone: 424-376-7211
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YS0200X |
| Taxonomy | School Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 164X00000X |
| Taxonomy | Licensed Vocational Nurse |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0200X |
| Taxonomy | Forensic Psychologist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 343900000X |
| Taxonomy | Non-emergency Medical Transport (VAN) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
GISLENE
KOUESSEU
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 424-376-7211