Healthcare Provider Details

I. General information

NPI: 1700100518
Provider Name (Legal Business Name): KIM L DESCH BSN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1734 COYOTE CT
VISTA CA
92084-3250
US

IV. Provider business mailing address

1301 VILLAGE DR APT 105
RAPID CITY SD
57701-8150
US

V. Phone/Fax

Practice location:
  • Phone: 858-682-4078
  • Fax: 760-634-2589
Mailing address:
  • Phone: 858-682-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number6518
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number436897
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: