Individual provider Active NPI

Kimdavy Chheng

  • Pharmacist
  • Roseville, CA
National Provider Identifier
1922831627
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
73340 Issued in CA
Practice address
1 Adventist Health Way
Roseville, CA 95661-3266
Phone
(916) 406-2514
NPI assigned
Aug 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 73340 CA Primary

Addresses

Primary practice location

1 Adventist Health Way
Roseville, CA 95661-3266

Mailing address

1 Adventist Health Way
Roseville, CA 95661-3266
Phone (916) 406-2514

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

LicenseStateTypeSpecialty
73340CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1922831627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ADVENTIST HEALTH WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613266",
            "telephone_number": "916-406-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ADVENTIST HEALTH WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613266",
            "telephone_number": "916-406-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHHENG",
        "first_name": "KIMDAVY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "73340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.