Individual provider Active NPI

Elaine Kooima, RN

  • School Registered Nurse
  • San Diego, CA
National Provider Identifier
1972126472
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
479518 Issued in CA
Practice address
12519 Camarero CT
San Diego, CA 92130-2279
Phone
(858) 829-7007
NPI assigned
May 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 479518 CA Primary

Addresses

Primary practice location

12519 Camarero CT
San Diego, CA 92130-2279

Mailing address

12519 Camarero CT
San Diego, CA 92130-2279
Phone (858) 829-7007

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
479518CAMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1972126472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12519 CAMARERO CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302279",
            "telephone_number": "858-829-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12519 CAMARERO CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302279",
            "telephone_number": "858-829-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOIMA",
        "first_name": "ELAINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "CA",
            "license": "479518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.