Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Jie Shi Yan, MD

Individual provider Nephrology Physician · NPI 1396744546

Dr. Jie Shi Yan, MD is a Nephrology in Simi Valley, California. Graduated from Stanford University School of Medicine in 2005, 21 years ago. Practices with California Kidney Medical Group Inc, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
21
Trained at
Stanford University School of Medicine
Licensed in
CA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2925 Sycamore Dr Ste 160
Simi Valley, CA 93065-1207
Phone: (805) 584-0177
Fax: (805) 584-1179
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1227 E Los Angeles Ave, Simi Valley, CA 93065-2871 — (805) 582-4000

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence A78071 (CA)

Record details

NPI number1396744546
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 19, 2005
Last updated in NPPESJuly 18, 2023
Certification dateJuly 18, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolSTANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice California Kidney Medical Group Inc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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