Haesook Kim, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95004733 Issued in CA

Practice address

2123 Ygnacio Valley Rd Ste K200
Walnut Creek, CA 94598-3336

Phone

(925) 926-0195

Fax

(925) 926-0194

NPI assigned

Aug 23, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Brighter BeginningsGroup PAC ID 8820274699, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Brighter Beginnings

  • Federally Qualified Health Center (FQHC)
  • Richmond, CA
  • NPI 1942638978
  Medicare reassignment Care Compare group NPD
• The West Oakland Health Council

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1285754234
  Medicare reassignment NPD
• Brighter Beginnings

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1629275839
  NPD
• The West Oakland Health Council

  • Psychiatric/Mental Health Nurse Practitioner
  • Oakland, CA
  • NPI 1043331630
  NPD
• The West Oakland Health Council

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1700906757
  NPD

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972020824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 YGNACIO VALLEY RD STE K200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983336",
            "telephone_number": "925-926-0195",
            "fax_number": "925-926-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 YGNACIO VALLEY RD STE K200",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983336",
            "telephone_number": "925-926-0195",
            "fax_number": "925-926-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HAESOOK",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95004733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alvin H Kim
• Charleen Lee Kim, M.D.
• Daniel Kim, M.D.
• Elisa Kim
• Eun-Jeong Kim, PHARMD
• Hyun Woo Kim
• Jeehong Kim, M.D
• Jennifer Kim, DPM
• Joanne Y. Kim, MD
• John Y. Kim, MD

• Nurse Practitioner in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.