Justine J Kim, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95034972 Issued in CA

Practice address

17310 Bear Valley Rd Ste 101
Victorville, CA 92395-7773

Phone

(909) 735-2446

NPI assigned

May 5, 2025

Last updated

Aug 28, 2025By 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

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cajon Medical Group PCGroup PAC ID 8820351174, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Cajon Medical Group PC

  • Internal Medicine Physician
  • Moreno Valley, CA
  • NPI 1841844891
  Medicare reassignment Care Compare group NPD
• Cajon Medical Group PC

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730707951
  NPD
• Cajon Medical Group, PC

  • Internal Medicine Physician
  • Temecula, CA
  • NPI 1245118082
  NPD
• Cajon Medical Group PC

  • Internal Medicine Physician
  • Redlands, CA
  • NPI 1326547183
  NPD (past)

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1841089067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17310 BEAR VALLEY RD STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957773",
            "telephone_number": "909-735-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17310 BEAR VALLEY RD STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957773",
            "telephone_number": "909-735-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUSTINE",
        "middle_name": "J",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95034972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abanoub Khalil, PHARMD
• Andrew S. Khan, D.O.
• Eman J Khan
• Abdelrahman Khater
• Jin-Hyuk Kim, D.D.S.
• Kellee Kim
• Sang Jo Kim, L.AC.
• Taejune Kim
• Yoonah Kim
• Tamara Lee Kimball

• Family Nurse Practitioner in Victorville, CA
• Providers in Victorville, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.