KELLI COSMAN (NPI# 1285180588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285180588 |
| Entity Type | Individual |
| Full Name | KELLI COSMAN |
| Practice Address |
6302 Thirteenth Ave Lucerne CA 95458 |
| Practice Telephone | 7072749101 |
| Practice Fax Number | 7072749192 |
| Mailing Telephone | 7072749101 |
| Mailing Fax Number | 7072749192 |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
7644-R | CA | Behavioral Health & Social Service Providers |
| Street Address |
6302 THIRTEENTH AVE |
| City | LUCERNE |
| State | CA |
| Zip Code | 95458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215140066 | County of Lake | Community/Behavioral Health | 6302 Thirteenth Ave, Lucerne, CA 95458-1024 | 2007-05-08 |
| 1457863821 | Karen Macall | Case Manager/Care Coordinator | 6302 Thirteenth Ave, Lucerne, CA 95458 | 2017-10-25 |
| 1548616089 | Jeffrey Shute | Technician, Other | 6302 Thirteenth Ave, Lucerne, CA 95458 | 2016-05-13 |
| 1861801151 | James William Isherwood IIi | Counselor | 6302 Thirteenth Ave, Lucerne, CA 95458 | 2014-08-12 |
| 1124361571 | John P Ely | Marriage & Family Therapist | 6302 Thirteenth Ave, Box 1024, Lucerne, CA 95458-1024 | 2013-04-04 |
| 1275722852 | Leroy Allen Fields | Counselor | 6302 Thirteenth Ave, Lucerne, CA 85458 | 2007-10-18 |
| 1720292329 | County of Lake | Community/Behavioral Health | 6302 Thirteenth Ave, Lucerne, CA 95458-1024 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619527512 | Shawna Dee Theodorou | Case Manager/Care Coordinator | 6302 Thirteeth Ave, Lucerne, CA 95458 | 2019-09-13 |
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
| 1750848396 | Catherine Denise Miller | Case Manager/Care Coordinator | 6302 13 Th Ave, Lucerne, CA 95458 | 2019-03-01 |
| 1043774193 | Priest Martinez | Counselor | 6300 E Hwy 20 Unit B, Lucerne, CA 95458 | 2019-01-23 |
| 1700308962 | Joao Adeles Barta | Case Manager/Care Coordinator | 6302 Thirteenth Av., Lucerne, CA 95458 | 2017-07-10 |
| 1154872737 | Deborah Annette Schmidt | Licensed Vocational Nurse | 6302 13th Ave., Lucerne, CA 95458 | 2016-10-19 |
| 1922496199 | Pearlina Drummond | Counselor | 3937 Foothill Drive, Lucerne, CA 95458 | 2014-12-22 |
| 1467881672 | Lucerne Elementary | Local Education Agency (LEA) | 3351 Country Club Drive, Lucerne, CA 95458 | 2013-11-07 |
| 1003245960 | Hilltop Recovery Services | Substance Abuse Rehabilitation Facility | 3937 Foothill Dr, Lucerne, CA 95458 | 2013-11-01 |
| 1053618652 | Chris Partida | Counselor | 6302 13th Ave, Lucerne, CA 95458 | 2011-02-16 |
| Find all providers in zip 95458 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043774193 | Priest Martinez | Counselor | 6300 E Hwy 20 Unit B, Lucerne, CA 95458 | 2019-01-23 |
| 1922496199 | Pearlina Drummond | Counselor | 3937 Foothill Drive, Lucerne, CA 95458 | 2014-12-22 |
| 1053618652 | Chris Partida | Counselor | 6302 13th Ave, Lucerne, CA 95458 | 2011-02-16 |
| 1093871592 | Robyn Carrie Rosin | Counselor | 6302 Thirteenth Avenue, Lucerne, CA 95458 | 2006-12-29 |
| 1740743293 | Holly Heather Austinson | Counselor | 6302 Thirteenth Avenue, Lucerne, CA 95458 | 2019-04-11 |
| 1437652385 | Jennifer Sue Nauert | Counselor | 6300 E. Hwy 20, Lucerne, CA 95458-9545 | 2018-03-16 |
| 1164943700 | Amber Marie Westphal | Counselor | 6302 13th Avenue, Lucerne, CA 95458 | 2017-07-05 |
| 1871034611 | Lonni Nicole Laven | Counselor | 6300 East Highway 20, Lucerne, CA 95458-0316 | 2017-03-13 |
| 1801255146 | Diana Rose Wilson-simkins | Counselor | 3937 Foothill Dr, Lucerne, CA 95458 | 2016-02-15 |
| 1922473222 | Melissa Dale | Counselor | 6300 E Highway 20, Lucerne, CA 95458 | 2015-12-11 |
| Find all providers in LUCERNE | ||||
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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.