Teresa Kimura, RN BSN CCM

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

620841 Issued in CA

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Phone

(619) 532-6400

NPI assigned

Oct 11, 2024

Sex

Female

Sole proprietor

No

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

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1689494049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMURA",
        "first_name": "TERESA",
        "credential": "RN BSN CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-11",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "620841",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "CA",
            "license": "620841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Michelle Ray Kimmel, NNP
• Michael Dale Kimmel, LCSW
• Herbert Clifford Kimmons Jr., M.D.
• Beth Ann Kimpson, NNP
• Bruce John Kimura, M.D.
• Rebecca Kincade
• Jamie E Kincaid
• Raelynn Marie Q. Kincaid, DPT
• Susan Ann Kincaid, FNP-BC
• Christopher Kincheloe, MFT

• Case Management Registered Nurse in San Diego, CA
• Providers in San Diego, CA by specialty
• Case Management Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.