Elijah Sangku-Daniel Kim, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

19455 Issued in CA

Practice address

277 Rancheros Dr Ste 301
San Marcos, CA 92069-2993

Phone

(855) 501-1004

Fax

(760) 471-4078

NPI assigned

Jan 3, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Elijah Sangku-Daniel Kim Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Richmond Area Multi-Services, Inc.

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1548312309
  Medicare reassignment NPD

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

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1225501109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 RANCHEROS DR STE 301",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692993",
            "telephone_number": "855-501-1004",
            "fax_number": "760-471-4078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Mercy Circle",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "92055",
            "country_code": "US",
            "telephone_number": "415-260-5997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4655 Telescope Ave",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920083766",
            "country_code": "US",
            "telephone_number": "415-260-5997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELIJAH",
        "middle_name": "SANGKU-DANIEL",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-03",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "19455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIJAH",
            "last_name": "KIM",
            "middle_name": "SANGKU-DANIEL",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Naveera Khan
• Khanda a Miller , a Professional Corp
• Kathlyn A Khoukaz, PSYD
• Bennett Kienast
• Chihee Kim
• Lucy Kim
• Denton Larmarr Kimball, O.D.
• Kameryn Kinney, PT
• Hannah Elizabeth Kirby, M.D.
• Heather Reichel Kirby, PT, DPT

• Psychiatric/Mental Health Nurse Practitioner in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.