Individual provider Active NPI

Kristina Shahla Kouri, NP

  • Nurse Practitioner
  • La Jolla, CA
National Provider Identifier
1225724818
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95023467 Issued in CA
Practice address
3855 Health Sciences Dr
La Jolla, CA 92093-3663
Phone
(800) 926-8273
NPI assigned
Apr 17, 2023
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95023467 CA Primary

Addresses

Primary practice location

3855 Health Sciences Dr
La Jolla, CA 92093-3663

Mailing address

File 57326
Los Angeles, CA 90074-0001

Other practice location 1

3714 Park Blvd Apt 4
San Diego, CA 92103-3663
Phone (714) 904-9700

Other practice location 2

1200 Garden View Rd
Encinitas, CA 92024-2477
Phone (800) 926-8273

Other practice location 3

16950 Via Tazon
San Diego, CA 92127-1607
Phone (800) 926-8273

Other practice location 4

910 Sycamore Ave
Vista, CA 92081-7832
Phone (800) 926-8273

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240722001161 CA Practitioner - Nurse Practitioner 0941746408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95023467CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California - Ucsd Medical Group CurrentSince May 28, 2024 Accepting new patients
Regents of the University of California Nurse Practitioner Current Accepting new patients
Regents of the University of California CurrentSince May 28, 2024 Accepting new patients

Locations

1200 Garden View Rd
Encinitas, CA 92024
Phone (760) 536-7682

3855 Health Sciences Dr
La Jolla, CA 92093
Phone (800) 926-8276

File 57326
Los Angeles, CA 90074

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

910 Sycamore Ave
Vista, CA 92081
Phone (760) 598-1700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1225724818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57326",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920933663",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3714 Park Blvd Apt 4",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921033663",
            "country_code": "US",
            "telephone_number": "714-904-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Garden View Rd",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920242477",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16950 Via Tazon",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921271607",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 Sycamore Ave",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920817832",
            "country_code": "US",
            "telephone_number": "800-926-8273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOURI",
        "first_name": "KRISTINA",
        "middle_name": "SHAHLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95023467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.