Kiandra Marie Kang, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A124414 Issued in CA

Practice address

1430 Freedom Blvd
Watsonville, CA 95076-2780

Phone

(831) 763-8400

NPI assigned

Apr 27, 2011

Last updated

Feb 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• County of Santa Cruz

  • Clinic/Center
  • Santa Cruz, CA
  • NPI 1659315430
  Medicare reassignment NPD
• County of Santa Cruz

  dba Watsonville Health Center

  • Federally Qualified Health Center (FQHC)
  • Watsonville, CA
  • NPI 1770709149
  Medicare reassignment NPD
• County of Santa Cruz

  dba Homeless Persons Health Project

  • Federally Qualified Health Center (FQHC)
  • Santa Cruz, CA
  • NPI 1285033514
  NPD
• County of Santa Cruz

  • Federally Qualified Health Center (FQHC)
  • Santa Cruz, CA
  • NPI 1578680310
  NPD

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1740571587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762780",
            "telephone_number": "831-763-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 FREEDOM BLVD",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762780",
            "telephone_number": "831-763-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 E Beach St",
            "address_purpose": "LOCATION",
            "city": "Watsonville",
            "state": "CA",
            "postal_code": "950764809",
            "country_code": "US",
            "telephone_number": "831-728-0222",
            "fax_number": "831-707-2777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Neilson St",
            "address_purpose": "LOCATION",
            "city": "Watsonville",
            "state": "CA",
            "postal_code": "950762468",
            "country_code": "US",
            "telephone_number": "831-728-0222",
            "fax_number": "831-707-2777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANG",
        "first_name": "KIANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-27",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A124414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Judson
• Julius M. Kong, D.D.S., Inc.
• Jennifer Kahl, RN
• Kaiser Foundation Health Plan Inc
• Devika Kajioka
• Emiko Kanzawa
• Karen Trinh DDS Inc.
• Prabhjot Kaur, REGISTERED NURSE
• Joshua Kayne
• Deirdre Kealy

• Pediatrics Physician in Watsonville, CA
• Providers in Watsonville, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.