Individual provider Active NPI

Kelcie Shoko Kawakami, PHARM.D.

  • Pharmacist
  • Fresno, CA
National Provider Identifier
1437628518
Registry record updated Nov 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
75516 Issued in CA
Practice address
740 W Alluvial Ave Ste 101
Fresno, CA 93711-5509
Phone
(800) 797-3543
Fax
(888) 222-1402
NPI assigned
Nov 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 75516 CA Primary

Addresses

Primary practice location

740 W Alluvial Ave Ste 101
Fresno, CA 93711-5509

Mailing address

1423 Descanso Drive
La Canada, CA 91011

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
75516CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1542499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542499200000",
    "number": "1437628518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 DESCANSO DRIVE",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "91011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 W ALLUVIAL AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937115509",
            "telephone_number": "800-797-3543",
            "fax_number": "888-222-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWAKAMI",
        "first_name": "KELCIE",
        "middle_name": "SHOKO",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-18",
        "last_updated": "2018-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "75516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2018; 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.