Christian Kenshin Job

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

701025 Issued in CA

Practice address

925 Bevins CT
Lakeport, CA 95453-9754

Phone

(707) 263-8382

NPI assigned

Mar 11, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1741651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1083413058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 BEVINS CT",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539754",
            "telephone_number": "707-263-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BEVINS CT",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539754",
            "telephone_number": "707-263-8382"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14440 Olympic Dr",
            "address_purpose": "LOCATION",
            "city": "Clearlake",
            "state": "CA",
            "postal_code": "954228809",
            "country_code": "US",
            "telephone_number": "707-263-8382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOB",
        "first_name": "CHRISTIAN",
        "middle_name": "KENSHIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-11",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "CA",
            "license": "701025",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "CA",
            "license": "701025",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "701025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik David Jameson, D.C.
• Patricia A Jarrard
• John Granville Jenkins, DDS
• Christopher Jensen, RRT
• Christina Jimenez
• Cassandra Marie Johnson
• Deborah Suzanne Johnson, LCSW
• Frederick L Johnson, M.D.
• Helen Vernetta Johnson, M.D.
• Sharie Johnson

• Administrator Registered Nurse in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Administrator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.

Verify at the official NPI Registry.