Active NPI
Jessica Jeehyun Kim
- Pharmacist
- Indio, CA
National Provider Identifier
1164910683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 76586
- Practice address
- 44100 Jefferson St Ste F
Indio, CA 92201-2715 - Phone
- (760) 895-6031
- NPI assigned
- Apr 30, 2018
- Last updated
- Apr 30, 2018
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 76586 | CA | Primary |
Addresses
Primary practice location
44100 Jefferson St Ste F
Indio, CA 92201-2715
Mailing address
4366 Jasmine Hill CT
Chino Hills, CA 91709-6171
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525046400000",
"number": "1164910683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4366 JASMINE HILL CT",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917096171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44100 JEFFERSON ST STE F",
"city": "INDIO",
"state": "CA",
"postal_code": "922012715",
"telephone_number": "760-895-6031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JESSICA",
"middle_name": "JEEHYUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-30",
"last_updated": "2018-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "76586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.