Individual provider Active NPI

Kristin Charyl Kieser Gascoyne, PHARM.D., CGP

  • Geriatric Pharmacist
  • San Jose, CA
National Provider Identifier
1578900569
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric PharmacistTaxonomy code 1835G0303X
License
2380 Issued in VA
Practice address
933 Northrup St
San Jose, CA 95126-3727
Phone
(408) 298-3020
Fax
(408) 298-3020
NPI assigned
May 30, 2013
Last updated
May 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 42172 CA
Geriatric Pharmacist 1835G0303X 2380 VA Primary

Addresses

Primary practice location

933 Northrup St
San Jose, CA 95126-3727

Mailing address

933 Northrup St
San Jose, CA 95126-3727
Phone (408) 298-3020

Other identifiers 3

IdentifierTypeStateIssuer
345238OtherILNABP
2380OtherVACGP
42172OtherCARPH

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
42172CAMDPharmacist
2380VAMDGeriatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1578900569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 NORTHRUP ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263727",
            "telephone_number": "408-298-3020",
            "fax_number": "408-298-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 NORTHRUP ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263727",
            "telephone_number": "408-298-3020",
            "fax_number": "408-298-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASCOYNE",
        "first_name": "KRISTIN",
        "middle_name": "CHARYL KIESER",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., CGP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "42172",
            "primary": false
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "VA",
            "license": "2380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "345238",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CGP",
            "identifier": "2380",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH",
            "identifier": "42172",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.