Kimberly D Alexander, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

559793 Issued in CA

Practice address

14574 Rochester Ave
Chino, CA 91710-6970

Phone

(909) 660-2322

NPI assigned

Aug 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saving Grace Mental Health Services

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1548927932
  NPD Authorized official

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

{
    "created_epoch": "1629504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629504000000",
    "number": "1649946336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14574 ROCHESTER AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917106970",
            "telephone_number": "909-660-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14574 ROCHESTER AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917106970",
            "telephone_number": "909-660-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "KIMBERLY",
        "middle_name": "D",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-21",
        "last_updated": "2021-08-21",
        "certification_date": "2021-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "559793",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "559793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farhan Alam, M.D.
• Lynelle Rose Alcantara
• Chanel Alcaraz, SPA
• Leticia Aleman, NP
• Kenneth Charles Alexander, PA
• Algos Inc., a Medical Corporation
• Ali M. Etemadian, D.O., Inc.
• Altaf Lutfe Ali, M.D.
• Nasir Nadir Ali, PHARM. D.
• Rula Alkhoudary, RDN

• Administrator Registered Nurse in Chino, CA
• Providers in Chino, CA by specialty
• Administrator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2021; 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.