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NPI Code Detail

MEDICARE: KIFLE GASHIE JIKAMO

MEDICARE: KIFLE GASHIE JIKAMO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner95026572CA

General Provider Information

NPI Number : 1811670615
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIFLE GASHIE JIKAMO
Provider Business Mailing Address
First Line : 728 N VALLEY VIEW DR
Second Line :
City : CHULA VISTA
State : CA
Zip : 91914-2432
Country : US
Telephone Number : 206-397-6173
Fax Number : 619-374-7300
Provider Business Practice Location Address
First Line : 3350 LA JOLLA VILLAGE DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92161-0002
Country : US
Telephone Number : 858-552-8585
Fax Number : 619-374-7300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2023
Last Update Date : 03/03/2026

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Directions to “ KIFLE GASHIE JIKAMO ” Practice Location

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