Individual provider Active NPI

Teresa Kim

  • Student in an Organized Health Care Education/Training Program
  • Palo Alto, CA
National Provider Identifier
1932082690
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4139 El Camino Way
Palo Alto, CA 94306-4010
Phone
(650) 617-8340
Fax
(408) 642-6052
NPI assigned
Jul 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4139 El Camino Way
Palo Alto, CA 94306-4010

Mailing address

1922 The Alameda Ste 316
San Jose, CA 95126-1461
Phone (408) 261-7777

Other names 1

  • Teresa Su Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum for Health CurrentSince Aug 3, 2025 Accepting new patients
Momentum for Health CurrentSince Aug 3, 2025 Accepting new patients

Locations

4139 El Camino Way
Palo Alto, CA 94306
Phone (650) 617-8340

1922 The Alameda
Ste 316
San Jose, CA 95126
Phone (408) 637-0341

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1932082690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 THE ALAMEDA STE 316",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261461",
            "telephone_number": "408-261-7777",
            "fax_number": "408-642-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 EL CAMINO WAY",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943064010",
            "telephone_number": "650-617-8340",
            "fax_number": "408-642-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-30",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "SU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.