Individual provider Active NPI

Allison Kikue Enomoto

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Sunnyvale, CA
National Provider Identifier
1366080517
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
NP95013101 Issued in CA
Practice address
1283 Oakmead Pkwy Ste B
Sunnyvale, CA 94085-4040
Phone
(408) 675-2010
NPI assigned
Dec 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013101 CA
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X NP95013101 CA Primary

Addresses

Primary practice location

1283 Oakmead Pkwy Ste B
Sunnyvale, CA 94085-4040

Mailing address

1283 Oakmead Pkwy Ste B
Sunnyvale, CA 94085-4040

Other practice location 1

25272 Marguerite Pkwy
Mission Viejo, CA 92692-2901
Phone (949) 581-9120 ext. 8221

Other practice location 2

580 N Rengstorff Ave
Mountain View, CA 94043-2894
Phone (800) 972-5547

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
I20200218002701 CA Practitioner - Nurse Practitioner 2668808148 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95013101CAMDPreventive Medicine/Occupational Environmental Medicine Physician
95013101CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic Medical Group of Orange County Inc Family CurrentSince Jan 14, 2020 Accepting new patients
Everside Health LLC, Maxar Technologies Preventive Medicine/Occupational Environmental Medicine CurrentSince Jun 8, 2025 Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients

Locations

25272 Marguerite Pkwy
Mission Viejo, CA 92692
Phone (949) 330-5070

11428 Kenyon Way
Rancho Cucamonga, CA 91701
Phone (909) 589-4098

921 Pacific Coast Hwy
Seal Beach, CA 90740
Phone (562) 598-0473

1283 Oakmead Pkwy
Ste B
Sunnyvale, CA 94085
Phone (408) 675-2010

33205 US Highway 79
Temecula, CA 92592
Phone (951) 303-3154

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: allison.enomoto.1@14940.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1366080517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1283 OAKMEAD PKWY STE B",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940854040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1283 OAKMEAD PKWY STE B",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940854040",
            "telephone_number": "408-675-2010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25272 Marguerite Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926922901",
            "country_code": "US",
            "telephone_number": "949-581-9120 x8221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "580 N Rengstorff Ave",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940432894",
            "country_code": "US",
            "telephone_number": "800-972-5547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENOMOTO",
        "first_name": "ALLISON",
        "middle_name": "KIKUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013101",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "NP95013101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.