Active NPI
Kimberly Dianne Job, RN
- Case Manager/Care Coordinator
- Modesto, CA
National Provider Identifier
1154570349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 719100
- Practice address
- 830 Scenic Dr BLDG 3
Modesto, CA 95350-6131 - Phone
- (209) 558-7400
- Fax
- (209) 558-8315
- NPI assigned
- Sep 12, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 719100 | CA | Primary |
Addresses
Primary practice location
830 Scenic Dr BLDG 3
Modesto, CA 95350-6131
Mailing address
830 Scenic Dr BLDG 3
Modesto, CA 95350-6131
Phone (209) 558-7400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 719100 | CA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1154570349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 SCENIC DR BLDG 3",
"city": "MODESTO",
"state": "CA",
"postal_code": "953506131",
"telephone_number": "209-558-7400",
"fax_number": "209-558-8315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 SCENIC DR BLDG 3",
"city": "MODESTO",
"state": "CA",
"postal_code": "953506131",
"telephone_number": "209-558-7400",
"fax_number": "209-558-8315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOB",
"first_name": "KIMBERLY",
"middle_name": "DIANNE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "CA",
"license": "719100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.