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

Prisca Kim

Individual provider Family Nurse Practitioner · NPI 1063233641

Prisca Kim is a Nurse Practitioner in San Bernardino, California. Qualified in 2024, 2 years ago. Practices with Faculty Physicians and Surgeons of Llusm, a 1,308-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2024
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Practice location Address checks out

375 W Hospitality Ln
San Bernardino, CA 92408-3203
Phone: (909) 888-9977
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95031605 (CA)

Record details

NPI number1063233641
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 17, 2024
Last updated in NPPESOctober 17, 2024
Certification dateOctober 17, 2024

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)
Group practice Faculty Physicians And Surgeons Of Llusm — 1308 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in San Bernardino