Soomi Kim

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

101 Callan Ave Ste 400
San Leandro, CA 94577-4523

Phone

(844) 828-2254

NPI assigned

Nov 19, 2018

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Maru

  • Community/Behavioral Health Agency
  • San Leandro, CA
  • NPI 1609341817
  NPD (past)

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

{
    "created_epoch": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1265901250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CALLAN AVE STE 400",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CALLAN AVE STE 400",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774523",
            "telephone_number": "844-828-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SOOMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ina Kim, DDS
• Jiyoon Kim
• Jorge Kim, MD
• Julie Ji Kim, LCSW
• Myong H Kim
• Yoo Jin Kim, DDS
• Nadia Kimbell
• Mira Kinebuchi
• Alexis King, MFT
• Alyssa T King

• Community Health Worker in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.