Individual provider Active NPI

Jennifer Kichinko

  • Pharmacist
  • Mill Valley, CA
National Provider Identifier
1699075663
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
54873 Issued in CA
Practice address
800 Redwood Hwy Frontage Rd Ste 100
Mill Valley, CA 94941-2350
Phone
(415) 360-9020
NPI assigned
Oct 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 54873 CA Primary

Addresses

Primary practice location

800 Redwood Hwy Frontage Rd Ste 100
Mill Valley, CA 94941-2350

Mailing address

800 Redwood Hwy Frontage Rd Ste 100
Mill Valley, CA 94941-2350

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

NPI Registry JSON

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1699075663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 REDWOOD HWY FRONTAGE RD STE 100",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 REDWOOD HWY FRONTAGE RD STE 100",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412350",
            "telephone_number": "415-360-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICHINKO",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "54873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.