Active NPI
Kimberly Pon
- Massage Therapist
- Daly City, CA
National Provider Identifier
1376855346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3076
- Practice address
- 75 Washington St
Daly City, CA 94014-2500 - Phone
- (650) 219-3570
- NPI assigned
- Jul 7, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3076 | CA | Primary |
Addresses
Primary practice location
75 Washington St
Daly City, CA 94014-2500
Mailing address
75 Washington St
Daly City, CA 94014-2500
Phone (650) 219-3570
Other names 1
- Kim Pon
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3076 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278460800000",
"number": "1376855346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 WASHINGTON ST",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940142500",
"telephone_number": "650-219-3570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 WASHINGTON ST",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940142500",
"telephone_number": "650-219-3570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PON",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-07",
"last_updated": "2010-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "3076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIM",
"last_name": "PON",
"credential": "CMT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Daly City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.