JMK Community Health Center, Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

JMK COMMUNITY HEALTH CENTER, INC

Practice address

14111 Van Ness Ave
Suite 5
Gardena, CA 90249-2950

Phone

(424) 396-3412

Fax

(424) 396-3427

NPI assigned

Mar 13, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jeanette Monique Kidd, FNP-C

Title

Ceo

Phone

(424) 396-3412

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1083155824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 N SANTA FE AVE",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902211427",
            "telephone_number": "310-638-1100",
            "fax_number": "424-396-3427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14111 VAN NESS AVE",
            "address_2": "SUITE 5",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902492950",
            "telephone_number": "424-396-3412",
            "fax_number": "424-396-3427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMK COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-13",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "424-396-3412",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144584806",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nichole Jimenez
• Patricia Jimenez
• Santiago Jimenez
• Victor Nesta Jimenez III
• Patricia Jimenezgonzalez
• Myoung Sun Jo, R.D.
• Valeria Joaquin Valencia
• Kayla Jocson
• Joel Goodman OD a Prof Corp
• Juliana N/a Jofili de Andrade Raimundo

• Family Nurse Practitioner in Gardena, CA
• Providers in Gardena, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.