Active NPI
Kimiko Deanna Krogh
- Peer Specialist
- Los Angeles, CA
National Provider Identifier
1790573475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-DHWPTY
- Practice address
- 500 S San Pedro St
Los Angeles, CA 90013-2102 - Phone
- (213) 728-8523
- Fax
- (805) 587-8094
- NPI assigned
- Apr 30, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-DHWPTY | CA | Primary |
Addresses
Primary practice location
500 S San Pedro St
Los Angeles, CA 90013-2102
Mailing address
500 S San Pedro St
Los Angeles, CA 90013-2102
Phone (805) 587-8094
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-DHWPTY | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1790573475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132102",
"telephone_number": "805-587-8094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S SAN PEDRO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900132102",
"telephone_number": "213-728-8523",
"fax_number": "805-587-8094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROGH",
"first_name": "KIMIKO",
"middle_name": "DEANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-30",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-DHWPTY",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.