Organization Active NPI

Kdpkii,Ink.

  • Assisted Living Facility (Behavioral Disturbances)
  • San Diego, CA
National Provider Identifier
1083364004
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X
Legal business name
KDPKII,INK.
Practice address
3739 Millikin Ave
San Diego, CA 92122-2415
Phone
(858) 583-6431
Fax
(858) 587-2802
NPI assigned
Mar 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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

Authorized official

Name
Mrs. Flora Kelly
Title
Administrator
Phone
(858) 583-6431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X Primary

Addresses

Primary practice location

3739 Millikin Ave
San Diego, CA 92122-2415

Mailing address

6311 Dennison St
San Diego, CA 92122-2401
Phone (858) 364-3158

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1083364004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 DENNISON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222401",
            "telephone_number": "858-364-3158",
            "fax_number": "858-587-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 MILLIKIN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222415",
            "telephone_number": "858-583-6431",
            "fax_number": "858-587-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KDPKII,INK.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "FLORA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "858-583-6431",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.

Verify at the official NPI Registry.