# KAISER PERMANENTE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124223094
- **Authorized official:** CONSTANCE MARY SULLIVAN RN, MFT (ADVICE NURSE)
- **Authorized official phone:** (619) 221-6107

## Contact information

- **Practice address:** 3420 KENYON ST, SAN DIEGO, CA 92110-5001
- **Practice address phone:** (619) 221-6107
- **Mailing address:** 3420 KENYON ST, SAN DIEGO, CA 92110-5001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | F219608 | CA | Yes |

## Other

- **Enumeration date:** 06/19/2007
- **Last updated:** 07/10/2008