Active NPI
Equip Health
- Psychiatric/Mental Health Nurse Practitioner
- La Jolla, CA
National Provider Identifier
1144905852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- EQUIP HEALTH
- Practice address
- 2674 Costebelle Dr Unit a
La Jolla, CA 92037-3516 - Phone
- (855) 387-4378
- NPI assigned
- Jun 20, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Grace Kim, PMHNP
- Title
- Psychiatric Nurse Practitioner
- Phone
- (855) 387-4378
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
2674 Costebelle Dr Unit a
La Jolla, CA 92037-3516
Mailing address
2674 Costebelle Dr Unit a
La Jolla, CA 92037-3516
National Provider Directory
National Provider DirectoryOwnership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Carlsbad, CA
- NPI 1982221768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687219200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687219200000",
"number": "1144905852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2674 COSTEBELLE DR UNIT A",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920373516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2674 COSTEBELLE DR UNIT A",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920373516",
"telephone_number": "855-387-4378"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EQUIP HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-20",
"last_updated": "2023-06-20",
"certification_date": "2023-06-20",
"status": "A",
"authorized_official_last_name": "KIM",
"authorized_official_first_name": "GRACE",
"authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
"authorized_official_telephone_number": "855-387-4378",
"authorized_official_credential": "PMHNP"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.