DR. KEITH J ANDERSEN PH.D.
NPI 1275558694
Psychologist - Cognitive & Behavioral in Bishop, CA

Active since July 13, 2006Opted out of Medicare · through Dec 29, 2026
152 PIONEER LN STE H, BISHOP, CA 93514(760) 873-6712(760) 873-6712 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Keith J Andersen Ph.d. NPPES

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

DR. KEITH J ANDERSEN PH.D. (NPI 1275558694) is an individual cognitive & behavioral provider in Bishop, California, licensed in California (14114) and active in the NPI registry since July 2006. He has opted out of Medicare through December 29, 2026.

NPPES Registry Identity

NPI1275558694
Entity TypeIndividualMale
Primary Taxonomy103TB0200X
Provider Legal NameDR. KEITH J ANDERSENCredential: PH.D.
Location Address152 PIONEER LN STE HBishop, CA 93514-2563
Mailing AddressPo Box 873Bishop, CA 93515-0873 · (760) 873-6712 · Fax (760) 873-6712
Fax(760) 873-6712
Sole ProprietorYes
Enumeration DateJuly 13, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1275558694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License Licensed in CA · 14114
Definition

A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.

152 PIONEER LN STE H, Bishop, CA 93514

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Keith J Andersen Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 29, 2022 through December 29, 2026.

Opt-Out Effective DateDecember 29, 2022
Opt-Out In Effect ThroughDecember 29, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

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

Pediatrics (Pediatric Allergy/Immunology)
152 PIONEER LN STE H
BISHOP, CA 93514
Pediatrics
152 PIONEER LN STE H
BISHOP, CA 93514

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 Keith Andersen's NPI number?

The NPI number for Keith Andersen is 1275558694. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Keith Andersen located?

Keith Andersen practices at 152 Pioneer Ln Ste H, Bishop, CA 93514. The listed phone number is (760) 873-6712.

What is Keith Andersen's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Is Keith Andersen enrolled in Medicare?

No. Keith Andersen has opted out of Medicare through December 29, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Keith Andersen was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.