Kimberly Perris, RN

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

License

462056 Issued in CA

Practice address

1 Harpst St
Arcata, CA 95521-8222

Phone

(707) 826-3146

Fax

(707) 826-5042

NPI assigned

Jan 10, 2014

Last updated

Jan 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• California State Polytechnic University, Humboldt

  • Student Health Clinic/Center
  • Arcata, CA
  • NPI 1104991744
  NPD (past)
• Humboldt State University

  • Student Health Clinic/Center
  • Arcata, CA
  • NPI 1659793602
  NPD (past)

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1801218870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARPST ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955218222",
            "telephone_number": "707-826-3146",
            "fax_number": "707-826-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARPST ST",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955218222",
            "telephone_number": "707-826-3146",
            "fax_number": "707-826-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRIS",
        "first_name": "KIMBERLY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "CA",
            "license": "462056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "462056",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Williams Pena Saravia, MSW, ASW
• Alexxa Jade Perdomo
• Eduardo Perez
• Esmeralda Lupita Perez
• Sade Adriel Baeza Perez
• Erin R. Peterson
• Richard D Pfeiffer, DDS
• Christina Phan, MS, BCBA
• Jay Kelly Piazza
• Karen Piekarski, LCSW

• Student Health Clinic/Center in Arcata, CA
• Providers in Arcata, CA by specialty
• Student Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.