GRACE KIM (NPI# 1417415662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417415662 |
| Entity Type | Individual |
| Full Name | GRACE KIM |
| Credential | MS, RD |
| Practice Address |
2120 Evergreen Dr San Bruno CA 94066-1828 |
| Practice Telephone | 6508080652 |
| Mailing Telephone | 6508080652 |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2019-03-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 86094017 | CA | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407417611 | Grace Kim | Acupuncturist | 414 N Coast Highway 101, Encinitas, CA 92024-2529 | 2019-06-27 |
| 1467971283 | Grace Y Kim | Student in an Organized Health Care Education/Training Program | Lacdmh Hucla 1000 W. Carson Street, Torrance, CA 90502 | 2017-09-13 |
| 1023405305 | Grace Eunheh Kim | Dentist | 7112 Ed Bluestein Blvd Ste 130, Austin, TX 78723-2924 | 2015-04-23 |
| 1679991897 | Grace Kim | Pediatrics | 925 E Southlake Blvd, Suite 100, Southlake, TX 76092 | 2014-04-03 |
| 1437572153 | Grace Kim | Occupational Therapist | 1607 W Redondo Beach Blvd, Gardena, CA 90247-3241 | 2014-01-31 |
| 1912335001 | Grace Jiin Kim | Acupuncturist | 61 Campbell Ave, Woodcliff Lake, NJ 07677-8061 | 2013-10-29 |
| 1255766119 | Grace Kim | Registered Nurse | 19416 37th Ave, Flushing, NY 11358-4003 | 2013-09-11 |
| 1366787103 | Grace G Kim | Physical Therapist | 375 Dover Chester Rd, Randolph, NJ 07869-3910 | 2012-12-05 |
| 1255684189 | Grace Donghwa Kim | Acupuncturist | 61 E 75th St Fl 2, New York, NY 10021-2739 | 2012-10-16 |
| 1326300534 | Grace Y Kim | Licensed Practical Nurse | 10850 N Oriole Ln, Mequon, WI 53092-4912 | 2012-06-13 |
| Street Address |
2120 EVERGREEN DR |
| City | SAN BRUNO |
| State | CA |
| Zip Code | 94066-1828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497392468 | Harold Relosimon | Behavior Technician | 901 Sneath Lane, Suite 105, San Bruno, Ca 94066, San Bruno, CA 94066 | 2019-12-09 |
| 1093365926 | Liana Greene | Behavior Technician | 1001 Sneath Lane #200, San Bruno, CA 94066 | 2019-09-12 |
| 1568018406 | Susan Page Gadegone | Community Health Worker | 931 San Bruno West Avenue Suite 2, San Bruno, CA 94066 | 2019-08-15 |
| 1184198780 | Sonya Oey Kramer | Pharmacist | 10 Bayhill Drive, San Bruno, CA 94066 | 2019-01-16 |
| 1316410350 | Brennen Marques Mcdowell | Behavioral Analyst | 101 Sneath Lane Ste. 200, 200, San Bruno, CA 94066 | 2019-01-02 |
| 1306317649 | Jacqueline R Lalucis | Behavior Technician | 751 Camino Plaza, San Bruno, Ca 94066, A, San Bruno, CA 94066 | 2018-12-16 |
| 1992275952 | Kenny Malunay | Behavior Technician | 75a El Camino Plaza, San Bruno, CA 94066 | 2018-12-03 |
| 1396236584 | Mariela Pena Yerena | Behavior Technician | 751 El Camino Plaza, Suite A, San Bruno, CA 94066 | 2018-05-23 |
| 1568845816 | Paula Leeanne Park | Physical Therapist | 106 Quail Point Cir, San Bruno, CA 94066 | 2015-07-06 |
| 1275921231 | C & C's Care Home | Assisted Living Facility | 2700 Oakmont Dr., San Bruno, CA 94066 | 2014-12-29 |
| Find all providers in zip 94066 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114475571 | I Lam Wong | Dietitian, Registered | 2000 Crystal Springs Rd, Apt 2123, San Bruno, CA 94066-4638 | 2016-09-14 |
| 1760938153 | Sonia Malhotra | Dietitian, Registered | 3110 Longview Dr, San Bruno, CA 94066-1647 | 2016-08-26 |
| 1508175134 | Alanna Nimau Vigil | Dietitian, Registered | 532 Beech Ave, San Bruno, CA 94066 | 2010-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083448 | Fuad Al Qudsi | Dietitian, Registered | 25874 Carmel Knolls Dr, Carmel, CA 93923-8830 | 2020-11-08 |
| 1700487535 | Katherine Zanville | Dietitian, Registered | 4928 Bellaire Ave, Valley Village, CA 91607-3419 | 2020-11-06 |
| 1760083711 | Gabriela E Zeagler | Dietitian, Registered | 1522 Halifax Way, El Dorado Hills, CA 95762-5841 | 2020-11-05 |
| 1427659796 | Yun Chieh Huang | Dietitian, Registered | 733 W Naomi Ave, Arcadia, CA 91007-7561 | 2020-11-03 |
| 1497356794 | Jelena Etemovic | Dietitian, Registered | 2517 S Alma St Apt 1, San Pedro, CA 90731-5738 | 2020-11-03 |
| 1588264337 | Apple Red Nutrition Services | Dietitian, Registered | 357 W. 2nd St, Suite #2, Loma Linda, CA 92354 | 2020-10-30 |
| 1912507708 | Eileen Hsiung | Dietitian, Registered | 830 Polaris Dr, Tustin, CA 92782-1720 | 2020-10-29 |
| 1912507831 | Aneeta Maria Vedula | Dietitian, Registered | 4371 Lombard Ave, Fremont, CA 94536-4929 | 2020-10-29 |
| 1336749449 | Sd Nutrition Group | Dietitian, Registered | 4295 Gesner St Ste 3a2, San Diego, CA 92117-6646 | 2020-10-28 |
| 1952901373 | Rubit Quintero-cobian | Dietitian, Registered | 3557 Willis Dr, Napa, CA 94558-2452 | 2020-10-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on GRACE KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.