Individual provider Active NPI

Diane Kay Koester, RN, NP

  • Adult Health Nurse Practitioner
  • La Jolla, CA
National Provider Identifier
1962663658
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP 11678 Issued in CA
Practice address
9834 Genesee Ave Ste 300
La Jolla, CA 92037-1215
Phone
(858) 625-4488
Fax
(858) 625-7995
NPI assigned
Jun 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NP 11678 CA Primary

Addresses

Primary practice location

9834 Genesee Ave Ste 300
La Jolla, CA 92037-1215

Mailing address

9834 Genesee Ave Ste 300
La Jolla, CA 92037-1215
Phone (858) 625-4488

Other names 1

  • Diane Kay Koester-Wilkerson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150731015860 CA Order and Referring Only - Nurse Practitioner 6709926363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
11678CAMDMental Health Counselor
NP 11678CAMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1962663658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE STE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371215",
            "telephone_number": "858-625-4488",
            "fax_number": "858-625-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9834 GENESEE AVE STE 300",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371215",
            "telephone_number": "858-625-4488",
            "fax_number": "858-625-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOESTER",
        "first_name": "DIANE",
        "middle_name": "KAY",
        "credential": "RN, NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "NP 11678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "KOESTER-WILKERSON",
            "middle_name": "KAY",
            "credential": "RN, NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.