Active NPI
Katherine Clifford, D.O.
- Pediatrics Physician
- Temecula, CA
National Provider Identifier
1255593802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 20A13682
- Practice address
- 44274 George Cushman CT
Temecula, CA 92592-5945 - Phone
- (951) 587-0992
- NPI assigned
- Jun 25, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 20A13682 | CA | Primary |
| Pediatrics Physician | 208000000X | DO 1625 | NV |
Addresses
Primary practice location
44274 George Cushman CT
Temecula, CA 92592-5945
Mailing address
33087 Vendange Dr
Winchester, CA 92596-4538
Phone (818) 730-4123
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO 1625 | Other | NV | MEDICAL LICENSE |
| 1255593802 | Medicaid | NV |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A13682 | CA | MD | Pediatrics Physician |
| DO 1625 | NV | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children's Hospital San Diego | Past | Accepting new patients | |
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Children's Hospital
- San Diego, CA
- NPI 1336359389
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653523200000",
"number": "1255593802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33087 VENDANGE DR",
"city": "WINCHESTER",
"state": "CA",
"postal_code": "925964538",
"telephone_number": "818-730-4123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44274 GEORGE CUSHMAN CT",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925925945",
"telephone_number": "951-587-0992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIFFORD",
"first_name": "KATHERINE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-25",
"last_updated": "2022-05-26",
"certification_date": "2022-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "20A13682",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NV",
"license": "DO 1625",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "DO 1625",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1255593802",
"state": "NV"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "10800 Magnolia Ave",
"city": "Riverside",
"state": "CA",
"country_code": "US",
"postal_code": "925053043",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.