Kyra Marie Dougherty Delapedraja, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP95002321 Issued in CA

Practice address

15400 Los Gatos Blvd
Los Gatos, CA 95032-2502

Phone

(408) 523-3640

NPI assigned

Apr 30, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kyra Marie Dougherty Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: kdelapedraja574664@direct.ochin.org

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1164666442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "408-523-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 LOS GATOS BLVD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322502",
            "telephone_number": "408-523-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAPEDRAJA",
        "first_name": "KYRA",
        "middle_name": "MARIE DOUGHERTY",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP95002321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22678522",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYRA",
            "last_name": "DOUGHERTY",
            "middle_name": "MARIE",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Donaldson Defigard, MD
• Robert F Dehn
• Alexander Del Real
• Kimberly Del Toro
• Terence J. Delaney, MD
• Margarita Delgado
• Nicholas Deliberato
• Carol L Delton
• Joseph A Denicola, PH.D.
• Elizabeth Yolanda Denys

• Pediatric Nurse Practitioner in Los Gatos, CA
• Providers in Los Gatos, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.