Active NPI
Jennifer D. Keen-Kim, PH.D
- Clinical Molecular Genetics Physician
- San Carlos, CA
National Provider Identifier
1063992386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Molecular Genetics Physician
- License
- DRN00000044
- Practice address
- 201 Industrial Rd Ste 410
San Carlos, CA 94070-2396 - Phone
- (650) 249-9090
- NPI assigned
- Aug 16, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Molecular Genetics Physician | 207SG0203X | DRN00000044 | CA | Primary |
Addresses
Primary practice location
201 Industrial Rd Ste 410
San Carlos, CA 94070-2396
Mailing address
201 Industrial Rd Ste 410
San Carlos, CA 94070-2396
Phone (650) 249-9090
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2080108 | Other | HCLD-ABB | |
| DRM00000056 | Other | CA | LICENSE |
| KEENJ1 | Other | NY | LICENSE |
| 26954 | Other | TN | LICENSE |
| DRN00000044 | Other | CA | LICENSE |
| 81357DIR0 | Other | NV | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DRN00000044 | CA | MD | Clinical Molecular Genetics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758067200000",
"number": "1063992386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 INDUSTRIAL RD STE 410",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940702396",
"telephone_number": "650-249-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 INDUSTRIAL RD STE 410",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940702396",
"telephone_number": "650-249-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEN-KIM",
"first_name": "JENNIFER",
"middle_name": "D.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-16",
"last_updated": "2025-09-17",
"certification_date": "2025-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0203X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Molecular Genetics",
"state": "CA",
"license": "DRN00000044",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCLD-ABB",
"identifier": "2080108",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DRM00000056",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "KEENJ1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "26954",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DRN00000044",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "81357DIR0",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.