Hailey Anne Kidder, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Phone

(229) 462-8907

NPI assigned

Apr 10, 2025

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

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1366237398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4384 HAMILTON ST APT 19",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921044378",
            "telephone_number": "229-462-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "229-462-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "HAILEY",
        "middle_name": "ANNE",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mraf Kidane-Mariam
• Zinnia Amaresh Kidane, NP
• Denise Annette Kidd
• Melissa Kidd, CHC
• Anthony Kidder
• Michele Kidder, RN
• Jocelia Juah Kidio
• Yasuko Kidokoro, M.D.
• Megan Kidron
• Kids on the Point OT, Inc

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.