Individual provider Active NPI

Kaelynn Dianne Jaime, FNP-C

  • Family Nurse Practitioner
  • Jurupa Valley, CA
National Provider Identifier
1831956739
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95028842 Issued in CA
Practice address
4234 Hidatsa St
Jurupa Valley, CA 92509-6874
Phone
(951) 858-7484
NPI assigned
Mar 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95028842 CA Primary

Addresses

Primary practice location

4234 Hidatsa St
Jurupa Valley, CA 92509-6874

Mailing address

4234 Hidatsa St
Jurupa Valley, CA 92509-6874
Phone (951) 858-7484

Other names 1

  • Mrs. Kaelynn Dianne Galeana Other name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240603001128 CA Practitioner - Nurse Practitioner 5890237135 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Health Plan of California, Inc. CurrentSince Apr 20, 2024 Accepting new patients
Molina Healthcare of California CurrentSince Oct 7, 2024 Accepting new patients
Universal Care CurrentSince May 7, 2024 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

Interoperability endpoints

  • Direct secure messaging: kjaime16266@direct-prd.molinahealthcare.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1831956739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 HIDATSA ST",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925096874",
            "telephone_number": "951-858-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4234 HIDATSA ST",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "925096874",
            "telephone_number": "951-858-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIME",
        "first_name": "KAELYNN",
        "middle_name": "DIANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95028842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAELYNN",
            "last_name": "GALEANA",
            "middle_name": "DIANNE",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jurupa Valley, CA

Sources for this page

Verify at the official NPI Registry.