Individual provider Active NPI

Jamie Mari Kusumoto, PHARMD

  • Pharmacist
  • San Francisco, CA
National Provider Identifier
1215243902
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61737 Issued in CA
Practice address
4131 Geary Blvd
1St Floor
San Francisco, CA 94118-3101
Phone
(415) 833-3649
NPI assigned
Aug 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61737 CA Primary

Addresses

Primary practice location

4131 Geary Blvd
1St Floor
San Francisco, CA 94118-3101

Mailing address

550 Battery St
Apt 318
San Francisco, CA 94111-2310
Phone (626) 945-0651

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
61737CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1215243902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 BATTERY ST",
            "address_2": "APT 318",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941112310",
            "telephone_number": "626-945-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 GEARY BLVD",
            "address_2": "1ST FLOOR",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941183101",
            "telephone_number": "415-833-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSUMOTO",
        "first_name": "JAMIE",
        "middle_name": "MARI",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61737",
            "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 Aug 19, 2010; 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.