K & J 1602 Managment Incorporate

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

K & J 1602 MANAGMENT INCORPORATE

Practice address

1602 Regene St
Pomona, CA 91766-5316

Phone

(909) 217-6817

NPI assigned

Jun 26, 2017

Organization subpart

No

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

Authorized official

Name

Valeria Al Khawaja

Title

Ceo

Phone

(909) 217-6817

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1336669803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 REGENE ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665316",
            "telephone_number": "909-217-6817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 REGENE ST",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665316",
            "telephone_number": "909-217-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K & J 1602 MANAGMENT INCORPORATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-26",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "AL KHAWAJA",
        "authorized_official_first_name": "VALERIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-217-6817"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathew Juarez
• Soedharsono Judo, DDS
• Teresita Jahja Judo, DDS
• Francis Demet Flor Mata Juloya
• Just US 4 Youth
• K D Ahn MD
• K. Mawaheb M.D. Faafp, Inc
• Cheridean Kaaialii
• Hrayr A Kabakian, MD
• David Michael Kadar, D.D.S.

• Intellectual Disabilities Intermediate Care Facility in Pomona, CA
• Providers in Pomona, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.