Active NPI
Christine Kim
- Counselor
- San Jose, CA
National Provider Identifier
1073255477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 4755 Raspberry PL
San Jose, CA 95129-1936 - Phone
- (302) 442-3174
- NPI assigned
- Apr 7, 2022
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
4755 Raspberry PL
San Jose, CA 95129-1936
Mailing address
4755 Raspberry PL
San Jose, CA 95129-1936
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3024423174 | Other | IDENTIFICATION |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | 3024423174 |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1073255477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4755 RASPBERRY PL",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951291936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4755 RASPBERRY PL",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951291936",
"telephone_number": "302-442-3174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "CHRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-07",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDENTIFICATION",
"identifier": "3024423174",
"state": null
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "3024423174",
"affiliation": "N",
"endpointDescription": "phone",
"address_1": "4755 Raspberry Pl",
"city": "San Jose",
"state": "CA",
"country_code": "US",
"postal_code": "951291936",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.