Dora Kissi

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

826 Issued in CA

Practice address

1428 N Waterman Ave Ste B
San Bernardino, CA 92404-5382

Phone

(909) 888-7180

NPI assigned

May 25, 2012

Last updated

Jun 1, 2016By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1841550647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 TAHOE ST",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922233158",
            "telephone_number": "909-435-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 N WATERMAN AVE STE B",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045382",
            "telephone_number": "909-888-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSI",
        "first_name": "DORA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "9051",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennith Dra Kirk
• Summer Victoria Kirkpatrick
• Celesti Kiroyan, PHARMD
• Daniel Kishner, HAD
• Sood Kisra, MD
• Kristin Kitagawa
• Daniel Steven Kitowski
• Kiyan Optometric
• Paul Arnold Kiyan, O.D.
• Robert Klacansky

• Advanced Practice Midwife in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Advanced Practice Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.