Kaiser Permanente

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

F219608 Issued in CA

Legal business name

KAISER PERMANENTE

Practice address

3420 Kenyon St
San Diego, CA 92110-5001

Phone

(619) 221-6107

NPI assigned

Jun 19, 2007

Organization subpart

No

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

Authorized official

Name

Constance Mary Sullivan, RN, MFT

Title

Advice Nurse

Phone

(619) 221-6107

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1124223094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 KENYON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 KENYON ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105001",
            "telephone_number": "619-221-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "ADVICE NURSE",
        "authorized_official_telephone_number": "619-221-6107",
        "authorized_official_credential": "RN, MFT"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "F219608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiser Foundation Hospitals (Kaiser Foundation Hospital San Diego HHA-Parent)
• Kaiser Foundation Hospitals (Kasier Foundation Hospital San Diego - Hospice)
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Foundation Hospitals
• Kaiser Permanente
• Kaiser Permanente
• Kaiser Permanente
• Arnold Kaiser
• Katelyn Kaiser

• Health Maintenance Organization in San Diego, CA
• Providers in San Diego, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.