Active NPI
Valentine Dekermendjian
- Pharmacist
- Honolulu, HI
National Provider Identifier
1881056844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 72905
- Practice address
- 3288 Moanalua Rd
Honolulu, HI 96819-1469 - Phone
- (808) 432-8425
- NPI assigned
- Mar 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3934 | HI | |
| Pharmacist | 183500000X | 72905 | CA | Primary |
Addresses
Primary practice location
3288 Moanalua Rd
Honolulu, HI 96819-1469
Mailing address
1277 Sinaloa Ave
Pasadena, CA 91104-3152
Other practice location 1
2235 Mercury Way Ste 145
Santa Rosa, CA 95407-5472
Phone (707) 535-7117
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72905 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1881056844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1277 SINALOA AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911043152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3288 MOANALUA RD",
"city": "HONOLULU",
"state": "HI",
"postal_code": "968191469",
"telephone_number": "808-432-8425"
}
],
"practiceLocations": [
{
"address_1": "2235 Mercury Way Ste 145",
"address_purpose": "LOCATION",
"city": "Santa Rosa",
"state": "CA",
"postal_code": "954075472",
"country_code": "US",
"telephone_number": "707-535-7117",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEKERMENDJIAN",
"first_name": "VALENTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-28",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "HI",
"license": "3934",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "72905",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "2045 N Franklin St",
"city": "Denver",
"state": "CO",
"country_code": "US",
"postal_code": "802055437",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.