Elizabeth C Kicko, WHNP, CNM, PHN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

95001452 Issued in CA

Practice address

4514 38TH Street
San Diego, CA 92105-1108

Phone

(760) 889-0774

NPI assigned

Nov 13, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

Practice roles

Interoperability endpoints

• Direct secure messaging: elizabeth.kickonp.p1@direct.ppnorcal.nextgenshare.com

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.

• Planned Parenthood Shasta Diablo Inc

  • Community Health Clinic/Center
  • Walnut Creek, CA
  • NPI 1003974064
  NPD (past)

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1982000352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 38TH STREET",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051108",
            "telephone_number": "760-889-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4514 38TH STREET",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051108",
            "telephone_number": "760-889-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICKO",
        "first_name": "ELIZABETH",
        "middle_name": "C",
        "credential": "WHNP, CNM, PHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "95001452",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Kiang, PHARMD
• Jinhui Kiang
• Marcy Kiar, LCSW
• Maxine Lorraine Kibble
• Kebron B Kibret
• Neha Viseshasai Kidambi, MD
• Mraf Kidane-Mariam
• Zinnia Amaresh Kidane, NP
• Denise Annette Kidd
• Melissa Kidd, CHC

• Women's Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Women's Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.