Nuru Khaliq

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

VN744330 Issued in CA

Practice address

935B Spring St
Placerville, CA 95667-4523

Phone

(510) 337-7950

NPI assigned

Nov 1, 2018

Reactivated

Sep 4, 2024

Last updated

Sep 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1912474461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "949-833-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935B SPRING ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956674523",
            "telephone_number": "510-337-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIQ",
        "first_name": "NURU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "deactivation_date": "2024-08-21",
        "reactivation_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN744330",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-18-74534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Keith, D.M.D.
• Denise Kellaher, D.O.
• Ann Jeanette Kenworthy, RN
• Krista Marie Key, SUDRC
• Vida Khaliki, PA
• Richard W Kiholm, D.D.S.
• Si Nae Kim
• Rebecca S. Kinnersley, REGISTERED NURSE
• Kinney Chiropractic, Inc.
• Lee Bernard Kinney, D.C

• Licensed Vocational Nurse in Placerville, CA
• Providers in Placerville, CA by specialty
• Licensed Vocational Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.