KIDUS DEGU
NPI 1336981141
Rehabilitation Practitioner in San Diego, CA

Q: What is Kidus Degu's NPI number?

The NPI number for Kidus Degu is 1336981141. It was assigned to this individual provider in the NPPES registry on June 11, 2024.

Q: What is Kidus Degu's specialty?

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

Q: When was this NPI record last updated?

The NPPES record for Kidus Degu was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 11, 2024

1260 MORENA BLVD STE 100, SAN DIEGO, CA 92110(619) 398-0355 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 5, 2025, Jun 11, 2024 (2 updates tracked since 2024).

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About Kidus Degu NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIDUS DEGU (NPI 1336981141) is an individual rehabilitation practitioner in San Diego, California and active in the NPI registry since June 2024. He maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1336981141

Entity TypeIndividualMale

Primary Taxonomy225400000X

Provider Legal NameKIDUS DEGU

Location Address1260 MORENA BLVD STE 100San Diego, CA 92110-3850

Mailing Address1260 Morena Blvd Ste 100San Diego, CA 92110-3850 · (619) 398-0355 · Fax (619) 398-0355

Phone(619) 398-0355

Sole ProprietorYes

Enumeration DateJune 11, 2024

Last NPPES UpdateAugust 5, 20252 updates tracked since enumeration

NPPES CertifiedAugust 5, 2025

✔ NPI 1336981141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225400000X

Definition

A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

Also ListedDay Training/Habilitation SpecialistTaxonomy 373H00000X

1260 MORENA BLVD STE 100, San Diego, CA 92110

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Secondary Practice Location 1

Location 13132 Jefferson StSan Diego, CA 92110-4421 · Phone (619) 683-3100

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAHARLIKA DEGRACIA

Case Manager/Care Coordinator