Individual provider Active NPI

Kimberly Michelle Cowley, FNP

  • Family Nurse Practitioner
  • Sunset Beach, CA
National Provider Identifier
1366210619
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028583 Issued in CA
Practice address
16501 Pacific Coast Hwy
Sunset Beach, CA 90742-2091
Phone
(562) 592-5100
NPI assigned
Dec 15, 2023
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95028583 CA Primary

Addresses

Primary practice location

16501 Pacific Coast Hwy
Sunset Beach, CA 90742-2091

Mailing address

12601 Edgemont LN Apt 43
Garden Grove, CA 92845-2963
Phone (714) 322-1564

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
I20250925004522 CA Practitioner - Nurse Practitioner 2769987163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victor Kabbany MD IncGroup PAC ID 5496281172, 3 clinicians

Practice addresses (Care Compare)

4281 Katella Ave
Suite 111
Los Alamitos, CA 90720-3588
Phone (562) 596-1667

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Kabbany MD Inc CurrentSince Jul 1, 2025 Accepting new patients
Derm Effects Inc. PastSince Dec 17, 2023 Accepting new patients

Locations

3650 South St
Ste 208
Lakewood, CA 90712
Phone (562) 596-1667

4281 Katella Ave
Ste 111
Los Alamitos, CA 90720
Phone (562) 554-5430

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1366210619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12601 EDGEMONT LN APT 43",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928452963",
            "telephone_number": "714-322-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16501 PACIFIC COAST HWY",
            "city": "SUNSET BEACH",
            "state": "CA",
            "postal_code": "907422091",
            "telephone_number": "562-592-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWLEY",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-15",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunset Beach, CA

Sources for this page

Verify at the official NPI Registry.