Active NPI
Nicole Kong, PHARMD
- Pharmacist
- South San Francisco, CA
National Provider Identifier
1568061109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 80824
- Practice address
- 1600 El Camino Real
South San Francisco, CA 94080-1206 - Phone
- (650) 757-3003
- NPI assigned
- Oct 24, 2020
- Last updated
- Oct 24, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 80824 | CA | Primary |
Addresses
Primary practice location
1600 El Camino Real
South San Francisco, CA 94080-1206
Mailing address
9989 Dona Neely Way
Elk Grove, CA 95757-6436
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
| License | State | Type | Specialty |
|---|---|---|---|
| 80824 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603497600000",
"number": "1568061109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9989 DONA NEELY WAY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957576436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 EL CAMINO REAL",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940801206",
"telephone_number": "650-757-3003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONG",
"first_name": "NICOLE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-24",
"last_updated": "2020-10-24",
"certification_date": "2020-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "80824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.