Individual provider Active NPI

Kateryna Kovalenko, PHARMD

  • Pharmacist
  • La Jolla, CA
National Provider Identifier
1558089292
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
84934 Issued in CA
Practice address
3855 Health Sciences Dr # 845
La Jolla, CA 92093-1503
Phone
(858) 822-6094
NPI assigned
Aug 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 84934 CA Primary

Addresses

Primary practice location

3855 Health Sciences Dr # 845
La Jolla, CA 92093-1503

Mailing address

3855 Health Sciences Dr # 845
La Jolla, CA 92093-1503

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
84934CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1558089292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DR # 845",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920931503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DR # 845",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920931503",
            "telephone_number": "858-822-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALENKO",
        "first_name": "KATERYNA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "84934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.