Jennifer Wiley Kim

Primary specialty

Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X

License

12866 Issued in CA

Practice address

1900 Sullivan Ave
Daly City, CA 94015-2200

Phone

(650) 991-6763

NPI assigned

Aug 30, 2012

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

Other names 1

• Jennifer Michelle Wiley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1457600884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 GARDEN ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153422",
            "telephone_number": "415-531-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SULLIVAN AVE",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152200",
            "telephone_number": "650-991-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JENNIFER",
        "middle_name": "WILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "CA",
            "license": "12866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WILEY",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mona Khoury
• Vivian Sami Khoury, DMD
• Anadelia B Kim, NP
• Esther Jin Kim, M.D.
• Han Seong Kim, D.C.
• Rachel Kim, PH.D
• Suk Won Kim
• Yong Hyeon Kim, D.C, LA.C
• Marya Susan Kimple, MS
• Tomoki Kimura, MD

• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Daly City, CA
• Providers in Daly City, CA by specialty
• Respiratory/Developmental/Rehabilitative Specialist/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.