Individual provider Active NPI

Ilana G Dorian Kern

  • Community Health Registered Nurse
  • Redwood City, CA
National Provider Identifier
1174654362
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN411610 Issued in CA
Practice address
802 Brewster Ave
Redwood City, CA 94063-1510
Phone
(650) 301-8649
Fax
(650) 364-6927
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN411610 CA Primary

Addresses

Primary practice location

802 Brewster Ave
Redwood City, CA 94063-1510

Mailing address

802 Brewster Ave
Redwood City, CA 94063-1510
Phone (650) 301-8649

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

LicenseStateTypeSpecialty
RN411610CAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174654362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 BREWSTER AVE",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631510",
            "telephone_number": "650-301-8649",
            "fax_number": "650-364-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 BREWSTER AVE",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940631510",
            "telephone_number": "650-301-8649",
            "fax_number": "650-364-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORIAN KERN",
        "first_name": "ILANA",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "RN411610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.