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

Kiwon Park, FNP-C

Individual provider Nurse Practitioner · NPI 1346124864

Kiwon Park, FNP-C is a Nurse Practitioner in Fullerton, California. Qualified in 2024, 2 years ago. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2025
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

111 W Valencia Dr
Fullerton, CA 92832-2317
Phone: (858) 717-2545
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 95036452 (CA)

Record details

NPI number1346124864
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedAugust 5, 2025
Last updated in NPPESAugust 7, 2025
Certification dateAugust 7, 2025
Mailing address111 W Valencia Dr, Fullerton, CA 92832-2317

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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