Susan Ann Kincaid, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

18150 Issued in CA

Practice address

1951 4TH Ave Ste 202
San Diego, CA 92101-2374

Phone

(619) 228-6170

NPI assigned

Dec 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Siti Medical Clinic

  • Clinical Nurse Specialist
  • San Diego, CA
  • NPI 1790088219
  NPD (past) Authorized official

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1295037760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 4TH AVE STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 4TH AVE STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012374",
            "telephone_number": "619-228-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "18150",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "18150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce John Kimura, M.D.
• Teresa Kimura, RN BSN CCM
• Rebecca Kincade
• Jamie E Kincaid
• Raelynn Marie Q. Kincaid, DPT
• Christopher Kincheloe, MFT
• Shelley L Kind, MS
• Joshua Titus Kindelan, M.D.
• Katherine Kindelan
• Alexandra Hope Kinderman

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.