Mary Katumika Kiilu, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

516304 Issued in CA

Practice address

7569 Hardy Ave
Rancho Cucamonga, CA 91730-7243

Phone

(909) 782-2180

Fax

(909) 987-4355

NPI assigned

Jan 27, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Faith Behavioral Health Group, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Goodyear, AZ
  • NPI 1194312876
  NPD Authorized official
• Faith Behavioral Health Group, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1801395876
  NPD Authorized official

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1811310808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7569 HARDY AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307243",
            "telephone_number": "909-782-2180",
            "fax_number": "909-987-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7569 HARDY AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307243",
            "telephone_number": "909-782-2180",
            "fax_number": "909-987-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIILU",
        "first_name": "MARY",
        "middle_name": "KATUMIKA",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "516304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suniel S. Khemlani, MD
• Amanda Jo Khouri, MD
• Melissa Michelle Khoury, DDS
• Khushy Senior Care Inc
• Kiddo Educational Services
• Albert Kim, D.P.M.
• Booil Kim, D.O.
• Donghan Kim, DDS
• Emily Kim
• Eunice Kim

• Registered Nurse in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.