Kidney Center of Simi Valley

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

KIDNEY CENTER OF SIMI VALLEY

Practice address

2950 Sycamore Dr
Suite # 100
Simi Valley, CA 93065-1210

Phone

(805) 584-2411

Fax

(805) 584-8604

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Viral Upponi

Title

Director of Accounts Receivable

Phone

(805) 433-7506

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1861437444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 940838",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930940838",
            "telephone_number": "805-433-7777",
            "fax_number": "805-433-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 SYCAMORE DR",
            "address_2": "SUITE # 100",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651210",
            "telephone_number": "805-584-2411",
            "fax_number": "805-584-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY CENTER OF SIMI VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "UPPONI",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "VIRAL",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "805-433-7506",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZZ1423Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC02638F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palita Khaledy, OT
• Elnaz Khalili, DPT
• Aleena Khan, DMD
• Amna Khan, DDS
• Ripsime Khazhakyan, DMD
• Kids Connection Developmental Therapy Center
• Kids Connections Developmental Therapy Center
• Bumjin Kim, L.AC
• Catherine Chong-Ae Kim, MD
• Chuhyun Kim, L.AC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.