Active NPI
Diane H. Kim, NP
- Nurse Practitioner
- San Francisco, CA
National Provider Identifier
1174038152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95009723
- Practice address
- 401 Parnassus Ave # 984
San Francisco, CA 94143 - Phone
- (415) 476-7000
- NPI assigned
- Dec 12, 2017
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 95009723 | CA | Primary |
Addresses
Primary practice location
401 Parnassus Ave # 984
San Francisco, CA 94143
Mailing address
6333 Telegraph Ave
Oakland, CA 94609-1359
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95009723 | CA | MD | Nurse Practitioner |
Interoperability endpoints
- diane.kim@398008301912068.direct.elationemr.com
- dkim71493@direct-ucsfmedicalcenter.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559088000000",
"number": "1174038152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6333 TELEGRAPH AVE",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946091359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 PARNASSUS AVE # 984",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94143",
"telephone_number": "415-476-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DIANE",
"middle_name": "H.",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-12",
"last_updated": "2019-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95009723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.