Siti Medical Clinic

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

18150 Issued in CA

Legal business name

SITI MEDICAL CLINIC

Practice address

1951 4TH Ave Ste 202
San Diego, CA 92101-2374

Phone

(619) 717-8484

NPI assigned

Dec 7, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Susan Ann Kincaid, FNPNPI 1295037760

Title

Part Owner/ Manger

Phone

(619) 717-8484

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Ann Kincaid, FNP-BC

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1295037760
  NPD (past) Authorized official

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1790088219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 4TH AVE #202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 4TH AVE STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012374",
            "telephone_number": "619-717-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SITI MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-07",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "KINCAID",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PART OWNER/ MANGER",
        "authorized_official_telephone_number": "619-717-8484",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": "CA",
            "license": "18150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Sitanggang
• Amy Montague Sitapati, MD
• Melina Nicole Sitaras, OTR/L
• James Michael Sites, IDC
• Sourignanh Sithavone
• David F Sitler, M.D
• Arun Sitsabeshon
• Viviana Sitto
• Matthew E. Sitzer, MD
• Traci Sitzer, PH.D.

• Clinical Nurse Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Nurse Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.