Kimberly Johnson

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A178634 Issued in CA

Practice address

20126 Stanton Ave Ste 200
Castro Valley, CA 94546-5270

Phone

(510) 881-4210

NPI assigned

Mar 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: kjohnson119018@direct-ucsfmedicalcenter.org
• Direct secure messaging: kjohnson573377@hisp.ehr.sutterhealth.org

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.

• UCSF Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Oakland, CA
  • NPI 1922124866
  Medicare reassignment NPD

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1437610573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-881-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20126 STANTON AVE STE 200",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465270",
            "telephone_number": "510-881-4210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 52nd St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946091809",
            "country_code": "US",
            "telephone_number": "510-428-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A178634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Theresa Johansson, PT
• John E Turns MD Inc
• John L Nelson
• John M Nakhla DDS, Inc
• Joy Lee Johnson, PSYD
• Nina M Johnson, MFT MARRIAGE AND FAM
• Nidhi Johri, M.D
• Amber Louise Jones, D.O., M.P.H.
• Kennedy Ann Jones, LMFT, APCC
• Kristin Marie Jones

• Pediatrics Physician in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.