Individual provider Active NPI

Minkyung So

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1003223033
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
103011 Issued in CA
Practice address
1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013
Phone
(310) 853-8211
NPI assigned
Jul 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 80802 CA
Marriage & Family Therapist 106H00000X 103011 CA Primary

Addresses

Primary practice location

1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013

Mailing address

560 W Main St Ste C229
Alhambra, CA 91801-3374
Phone (310) 853-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
80802CAMDClinical Social Worker
103011CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1003223033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MAIN ST STE C229",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918013374",
            "telephone_number": "310-853-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013",
            "telephone_number": "310-853-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "MINKYUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "80802",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "103011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.