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General NPI Number Information
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NPI Number | 1831849413
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Entity Type | Organization
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Legal Business Name | KESEM INC
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 17609 VENTURA BLVD STE 305
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City | ENCINO
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State | CA
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Zip | 91316-5130
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Country | US
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Telephone | 818-571-9841
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Fax |
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Provider Business Mailing Address
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Address Line | 17609 VENTURA BLVD STE 305
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City | ENCINO
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State | CA
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Zip | 91316-5130
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Country | US
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Telephone | 818-571-9841
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | SERENA JONES
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Credential |
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Telephone | 760-822-0773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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