NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

  • Community/Retail Pharmacy
  • Scotts Valley, CA
National Provider Identifier
1114505765
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Practice address
5615 Scotts Valley Drive
FL 1, RM 14R06
Scotts Valley, CA 95066
Phone
(831) 430-2900
Fax
(831) 430-2714
NPI assigned
Apr 1, 2021
Last updated
Apr 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Authorized official

Name
Kathryn Renouard Brown
Title
VP, Pharmacy Operations & SVCS Ncal
Phone
(510) 625-6972

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

5615 Scotts Valley Drive
FL 1, RM 14R06
Scotts Valley, CA 95066

Mailing address

1800 Harrison St FL 13
Oakland, CA 94612-3466

Other names 1

  • Kaiser Permanente Pharmacy #772 Other name

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation HLTH379 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

5615 Scotts Valley Dr
Fl 1
Scotts Valley, CA 95066
Phone (831) 430-2900

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617235200000",
    "number": "1114505765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HARRISON ST FL 13",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 SCOTTS VALLEY DRIVE",
            "address_2": "FL 1, RM 14R06",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "95066",
            "telephone_number": "831-430-2900",
            "fax_number": "831-430-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "RENOUARD",
        "authorized_official_title_or_position": "VP, PHARMACY OPERATIONS & SVCS NCAL",
        "authorized_official_telephone_number": "510-625-6972"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Pharmacy #772",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scotts Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.