Keandrea Edmund
Community Health Worker in Barstow, CA. Individual provider (NPI-1).
NPI number1033570403
StatusActive
Last updated in NPPESMar 14, 2016
Details
- NPI
- 1033570403
- Entity type
- Individual (NPI-1)
- Name
- Keandrea Edmund
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2016
- Last updated
- Mar 14, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
222 E Main St Ste 117Barstow, CA 92311-2361
Phone 760-255-1496 · Fax 760-513-4675
Mailing address
222 E Main St Ste 117Barstow, CA 92311-2361
Phone 760-255-1496 · Fax 760-513-4675
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 44 Community Health Worker providers in Barstow · All 759 providers in Barstow
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