Provider Demographics
NPI:1265855498
Name:KJOSE, ANNA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:KJOSE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 NW 187TH TER
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-7688
Mailing Address - Country:US
Mailing Address - Phone:636-795-5480
Mailing Address - Fax:
Practice Address - Street 1:3351 W ROCK CREEK RD STE 120
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2463
Practice Address - Country:US
Practice Address - Phone:405-801-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X
OK1371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health