JOANNE KIM NP NPI 1053037192

NPI Information

  • NPI: 1053037192
  • Provider Name: JOANNE KIM, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3657 VAN BUREN BLVD
    RIVERSIDE, CA
    ZIP 92503
  • Phone: (909) 238-7966

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NPI Details

Joanne Kim, NP is a family nurse practitioner in Riverside, CA with 4 years of experience. Joanne Kim, NP NPI is 1053037192. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3657 VAN BUREN BLVD
RIVERSIDE, CA
ZIP 92503-249
Phone: (909) 238-7966

The NPI 1053037192 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/19/2022 and was last updated on 10/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily95022581CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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