Provider Demographics
NPI:1598005035
Name:OWENS, KEYANA MONET (BA)
Entity Type:Individual
Prefix:MRS
First Name:KEYANA
Middle Name:MONET
Last Name:OWENS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:KEYANA
Other - Middle Name:MONET
Other - Last Name:BEAMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92836-0919
Mailing Address - Country:US
Mailing Address - Phone:714-680-9000
Mailing Address - Fax:714-680-8233
Practice Address - Street 1:801 E CHAPMAN AVE STE 203
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3846
Practice Address - Country:US
Practice Address - Phone:714-680-9000
Practice Address - Fax:714-680-8233
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X, 225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health