Individual provider Active NPI

Kim-Long Hua-Rupp

  • Psychiatry Physician
  • Stockton, CA
National Provider Identifier
1104566736
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A197285 Issued in CA
Practice address
1805 N California St Ste 201
Stockton, CA 95204-6032
Phone
(209) 645-4005
Fax
(209) 645-6344
NPI assigned
Mar 31, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A197285 CA Primary

Addresses

Primary practice location

1805 N California St Ste 201
Stockton, CA 95204-6032

Mailing address

1805 N California St Ste 201
Stockton, CA 95204-6032
Phone (209) 645-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1805 N California St
Suite 201
Stockton, CA 95204-6032

586 Carolina St
Woodbridge, CA 95258-9754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1104566736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 201",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046032",
            "telephone_number": "209-645-4005",
            "fax_number": "209-645-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 201",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046032",
            "telephone_number": "209-645-4005",
            "fax_number": "209-645-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUA-RUPP",
        "first_name": "KIM-LONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A197285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.