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

Jiyeon Kim, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1043780216

Jiyeon Kim, NURSEPRACTITIONER is a Nurse Practitioner in Reseda, California. Qualified in 2013, 13 years ago. Accepts Medicare assignment. Licensed in California.

Years since qualifying
13
Licensed in
CA
In the registry since
2018

Practice location Address checks out

18107 Sherman Way Ste 200
Reseda, CA 91335-8802
Phone: (818) 783-1002
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95006590 (CA)

Record details

NPI number1043780216
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedNovember 30, 2018
Last updated in NPPESMarch 31, 2022
Certification dateMarch 31, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Reseda