1. Home
  2. Directory
  3. California
  4. Escondido
  5. Peer Specialist
  6. NPI Profile
Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MS. KELLY JANINE ANDERSON SUDRC I #24481
NPI 1104736990
Peer Specialist in Escondido, CA

Active since September 11, 2026
161 N DATE ST, ESCONDIDO, CA 92025(760) 291-4788 Get Directions Write a Review

NPPES record added: September 11, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Ms. Kelly Janine Anderson Sudrc I #24481 NPPES

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

MS. KELLY JANINE ANDERSON SUDRC I #24481 (NPI 1104736990) is an individual peer specialist in Escondido, California, licensed in California (MPSSQTUFZB) and active in the NPI registry since September 2026.

NPPES Registry Identity

NPI1104736990
Entity TypeIndividualFemale
Primary Taxonomy175T00000X
Provider Legal NameMS. KELLY JANINE ANDERSONCredential: SUDRC I #24481
Location Address161 N DATE STEscondido, CA 92025-3405
Mailing Address24934 Abalar WayRamona, CA 92065-4649 · (855) 740-2487
Phone(760) 291-4788
Sole ProprietorNo
Enumeration DateSeptember 11, 2026
NPPES CertifiedSeptember 11, 2026
✔ NPI 1104736990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
License✔ Licensed in CA · MPSSQTUFZB
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 24481 (CA)
Also ListedBehavior TechnicianTaxonomy 106S00000X · License RBT262840842 (CA)
161 N DATE ST, Escondido, CA 92025
Open in Google Maps ↗

Other Identifiers 6

OtherNONNUMERICCA · Peer Specialization In In-crisis Care - Calmhsa Certified
OtherNONNUMERICCA · Justice-involved Peer Specialization - Calmhsa Certified
MedicaidMPSS-QTUFZBCA
OtherBACB1530984CA · Registered Behavior Technician Through Bacb Licensure
OtherNONNUMERICCA · National Peer Recovery Support Specialist Through Naadac Certification
OtherNONNUMERICCA · Peer Specialization In Parents Family Members And Caregivers Calmhsa Certified

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.

DELIENID HEREDIA LVN
Licensed Vocational Nurse
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 443-9727
THOMAS KNUTSON MD INC
Orthopaedic Surgery
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 743-4789
RUTH P ZARATE LVN
Licensed Vocational Nurse
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 745-7786
MISS MARIA CRISTINA DELGADILLO REYES LVN
Licensed Vocational Nurse
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 745-7786
KAMBRIA KELLEY JACKSON LVN
Licensed Vocational Nurse
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 745-7786
KIRA WILLIS
Licensed Vocational Nurse
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 291-4788
MS. ALINA MASLYUKOVA
Peer Specialist
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 291-4788
SUSAN LYNN SHAFER
Counselor (Addiction (Substance Use Disorder))
161 N DATE ST
ESCONDIDO, CA 92025
San Diego County (760) 745-7786

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 Anderson's NPI number?

The NPI number for Kelly Anderson is 1104736990. It was assigned to this individual provider in the NPPES registry on September 11, 2026.

Where is Kelly Anderson located?

Kelly Anderson practices at 161 N Date St, Escondido, CA 92025. The listed phone number is (760) 291-4788.

What is Kelly Anderson's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kelly Anderson was last updated on September 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.