St. Junipero Clinic, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A85492 Issued in CA

Legal business name

ST. JUNIPERO CLINIC, INC.

Practice address

333 Abbott St Ste C
Salinas, CA 93901-4486

Phone

(831) 288-8811

Fax

(831) 288-8866

NPI assigned

Dec 4, 2017

Organization subpart

No

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

Authorized official

Name

Steve Darmawan, MDNPI 1720079924

Title

President

Phone

(831) 917-7737

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Junipero Children's Clinic Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steve Darmawan, MD

  • Pediatrics Physician
  • Salinas, CA
  • NPI 1720079924
  NPD Authorized official
• Annalisa Sergent, CPNP

  • Pediatric Nurse Practitioner
  • Monterey, CA
  • NPI 1699438515

  Pediatrics

  NPD
• Kimberly A Timperlake-Olivares, NP

  • Pediatrics Physician
  • Salinas, CA
  • NPI 1184350712
  NPD

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1912412644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 ABBOTT ST STE C",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014486",
            "telephone_number": "831-288-8811",
            "fax_number": "831-998-7809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 ABBOTT ST STE C",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939014486",
            "telephone_number": "831-288-8811",
            "fax_number": "831-288-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUNIPERO CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "DARMAWAN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-917-7737",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A85492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176005001",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "stjuniperochildrensclinic.com",
            "affiliation": "N",
            "address_1": "333 Abbott St Ste C",
            "city": "Salinas",
            "state": "CA",
            "country_code": "US",
            "postal_code": "939014486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Junipero Children's Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jody Spraggins, MHS
• Evelyn Sprinkle, PHD, BCBA-D
• Govindaraj Srinivasan Manivannan, PT, DPT(NEURO), CCI
• Shylaja Srinivasan, MD
• Emily St Jacques, OTR
• John Stafford
• Katerina Pike Stafford, LMFT
• Fe Calumpong Stallworth, RN
• Stanley Hwang MD Professional Corporation
• Tasha Stanley

• Pediatrics Physician in Salinas, CA
• Providers in Salinas, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.