NPIMap

Organization Active NPI

Kaiser Permanente

  • Health Maintenance Organization
  • Walnut Creek, CA
National Provider Identifier
1093168312
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
27912 Issued in CA
Legal business name
KAISER PERMANENTE
Practice address
710 S Broadway
Walnut Creek, CA 94596-5294
Phone
(925) 295-2960
NPI assigned
Jul 21, 2016
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Dr. Marilyn O'Connor, PSYD
Title
Chemical Dependency Manager
Phone
(925) 295-4596

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 27912 CA Primary

Addresses

Primary practice location

710 S Broadway
Walnut Creek, CA 94596-5294

Mailing address

710 S Broadway
Walnut Creek, CA 94596-5294
Phone (925) 295-2960

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Daniel Gussin185 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

710 S Broadway
Walnut Creek, CA 94596
Phone (925) 295-4145

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1093168312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S BROADWAY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965294",
            "telephone_number": "925-295-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S BROADWAY",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965294",
            "telephone_number": "925-295-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2023-09-07",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "CHEMICAL DEPENDENCY MANAGER",
        "authorized_official_telephone_number": "925-295-4596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "27912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondingg",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 S Broadway",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945965294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.