KRISTOFER KEDAR PETTWAY
NPI 1427783315
Prevention Professional in Los Angeles, CA

Q: What is Kristofer Pettway's NPI number?

The NPI number for Kristofer Pettway is 1427783315. It was assigned to this individual provider in the NPPES registry on July 23, 2022.

Q: What is Kristofer Pettway's specialty?

The primary specialty registered for this NPI is Prevention Professional with taxonomy code 405300000X.

Q: When was this NPI record last updated?

The NPPES record for Kristofer Pettway was last updated on July 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.

Active since July 23, 2022

411 S NORMADE AVE APT 732, LOS ANGELES, CA 90020(516) 919-0061 Get Directions Write a Review

NPPES record last updated: July 23, 2022. Verified against the NPPES registry weekly; last sync: October 04, 2026.

On this page

About Kristofer Kedar Pettway NPPES

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

KRISTOFER KEDAR PETTWAY (NPI 1427783315) is an individual prevention professional provider in Los Angeles, California, licensed in New York (19393832) and active in the NPI registry since July 2022.

NPPES Registry Identity

NPI1427783315

Entity TypeIndividualMale

Primary Taxonomy405300000X

Provider Legal NameKRISTOFER KEDAR PETTWAY

Location Address411 S NORMADE AVE APT 732Los Angeles, CA 90020-3396

Mailing Address411 S Normade Ave Apt 732Los Angeles, CA 90020-3396 · (516) 919-0615

Phone(516) 919-0061

Sole ProprietorYes

Enumeration DateJuly 23, 2022

NPPES CertifiedJuly 23, 2022

✔ NPI 1427783315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPrevention ProfessionalOther Service Providers

Taxonomy Code405300000X

License✔ Licensed in NY · 19393832

Definition

Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work.

411 S NORMADE AVE APT 732, Los Angeles, CA 90020

Open in Google Maps ↗

Other Providers at the Same Location NPPES

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

ALDEN JULES BEHAVIOR TECHNICIAN

Behavior Technician

411 S NORMADE AVE APT 732
LOS ANGELES, CA 90020

Los Angeles County (516) 776-3226

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 Kristofer Pettway's NPI number?

The NPI number for Kristofer Pettway is 1427783315. It was assigned to this individual provider in the NPPES registry on July 23, 2022.

Where is Kristofer Pettway located?

Kristofer Pettway practices at 411 S Normade Ave Apt 732, Los Angeles, CA 90020. The listed phone number is (516) 919-0061.

What is Kristofer Pettway's specialty?

The primary specialty registered for this NPI is Prevention Professional with taxonomy code 405300000X.

When was this NPI record last updated?

The NPPES record for Kristofer Pettway was last updated on July 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.