Active NPI
Jaeny Kim, FNP-C
- Family Nurse Practitioner
- Los Gatos, CA
National Provider Identifier
1376923631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95001340
- Practice address
- 800 Pollard Rd
Building a
Los Gatos, CA 95032 - Phone
- (408) 688-2082
- NPI assigned
- Jun 2, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95001340 | CA | Primary |
Addresses
Primary practice location
800 Pollard Rd
Building a
Los Gatos, CA 95032
Mailing address
800 Pollard Rd
Building a
Los Gatos, CA 95032
Phone (408) 688-2082
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95001340 | CA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433203200000",
"number": "1376923631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 POLLARD RD",
"address_2": "BUILDING A",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "95032",
"telephone_number": "408-688-2082",
"fax_number": "408-866-4270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POLLARD RD",
"address_2": "BUILDING A",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "95032",
"telephone_number": "408-688-2082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAENY",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-02",
"last_updated": "2015-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95001340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.