Individual provider · Type 1 NPI

Kelly Janine Anderson, SUDRC I #24481

Peer Specialist · Escondido, CA

NPI number 1104736990 Active

Practice location

161 N Date St
Escondido, CA 92025-3405

Call (760) 291-4788 Map

Mailing address

24934 Abalar Way
Ramona, CA 92065-4649

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X24481 (CA)
Behavior Technician 106S00000XRBT262840842 (CA)
Peer Specialist Primary 175T00000XMPSSQTUFZB (CA)

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1104736990

Kelly Janine Anderson, SUDRC I #24481's National Provider Identifier is 1104736990, issued on Sep 11, 2026. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Escondido, CA. The record was last updated on Sep 11, 2026.