Active NPI
Jenny Im, ND
- Naturopath
- Fullerton, CA
National Provider Identifier
1174236236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- ND1305
- Practice address
- 1400 N Harbor Blvd Ste 120
Fullerton, CA 92835-4110 - Phone
- (714) 773-7000
- NPI assigned
- Jan 3, 2023
- 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 |
|---|---|---|---|---|
| Naturopath | 175F00000X | ND1305 | CA | Primary |
Addresses
Primary practice location
1400 N Harbor Blvd Ste 120
Fullerton, CA 92835-4110
Mailing address
3683 S Bear St Unit J
Santa Ana, CA 92704-8240
Phone (602) 770-3457
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND1305 | CA | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nuvida KMC | Current | Accepting new patients |
Locations
1400 N Harbor Blvd
Ste 120
Fullerton, CA 92835
Phone (714) 773-7000
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Acupuncturist
- Fullerton, CA
- NPI 1851540009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1174236236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3683 S BEAR ST UNIT J",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927048240",
"telephone_number": "602-770-3457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N HARBOR BLVD STE 120",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928354110",
"telephone_number": "714-773-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IM",
"first_name": "JENNY",
"credential": "ND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-03",
"last_updated": "2023-01-03",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "CA",
"license": "ND1305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.