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KELLY KEOMUANGCHANH
NPI 1053060202
Counselor - Addiction (Substance Use Disorder) in Ceres, CA

Active since March 23, 2022
1768 MITCHELL RD STE 301, CERES, CA 95307(209) 353-4838 Get Directions Write a Review

NPPES record last updated: December 10, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly Keomuangchanh NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY KEOMUANGCHANH (NPI 1053060202) is an individual addiction (substance use disorder) provider in Ceres, California and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1053060202
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELLY KEOMUANGCHANH
Location Address1768 MITCHELL RD STE 301Ceres, CA 95307-2156
Mailing Address1768 Mitchell Rd Ste 301Ceres, CA 95307-2156 · (209) 353-4838
Phone(209) 353-4838
Sole ProprietorNo
Enumeration DateMarch 23, 2022
Last NPPES UpdateDecember 10, 2024
NPPES CertifiedDecember 10, 2024
✔ NPI 1053060202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
1768 MITCHELL RD STE 301, Ceres, CA 95307
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIZBETH SANTILLAN PINEDA
Counselor (Addiction (Substance Use Disorder))
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838
ANGELIQUE MARIA GARCIA
Counselor (Addiction (Substance Use Disorder))
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838
JEREMY SOTO
Counselor (Addiction (Substance Use Disorder))
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838
VALERIA TABAREZ
Counselor (Addiction (Substance Use Disorder))
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838
DAISY ALVIZO
Counselor (Addiction (Substance Use Disorder))
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838
EBONY SHEALEASE DAVIS
Counselor (Addiction (Substance Use Disorder))
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838
PATHANA LUANGRATH
Counselor (Addiction (Substance Use Disorder))
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838
DULCE FARFAN RUIZ
Licensed Vocational Nurse
1768 MITCHELL RD STE 301
CERES, CA 95307
Stanislaus County (209) 353-4838

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Keomuangchanh's NPI number?

The NPI number for Kelly Keomuangchanh is 1053060202. It was assigned to this individual provider in the NPPES registry on March 23, 2022.

Where is Kelly Keomuangchanh located?

Kelly Keomuangchanh practices at 1768 Mitchell Rd Ste 301, Ceres, CA 95307. The listed phone number is (209) 353-4838.

What is Kelly Keomuangchanh's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kelly Keomuangchanh was last updated on December 10, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.