Caitlyn Jeein Park

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017087 Issued in CA

Practice address

7212 Orangethorpe Ave Ste 9a
Buena Park, CA 90621-4668

Phone

(714) 503-6550

NPI assigned

Aug 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allcare Family Clinic Inc.

  • Family Medicine Physician
  • Norco, CA
  • NPI 1972742328
  Medicare reassignment NPD
• Allcare Family Medical Group, Inc

  • Family Medicine Physician
  • Buena Park, CA
  • NPI 1083159057
  Medicare reassignment NPD
• BVC Therapy Group

  • Physical Therapist
  • Buena Park, CA
  • NPI 1255472221
  NPD
• St Jude Hospital Inc

  • General Acute Care Hospital
  • Fullerton, CA
  • NPI 1194926279
  NPD (past)

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1003462722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 ORANGETHORPE AVE STE 9A",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906214668",
            "telephone_number": "714-503-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7212 ORANGETHORPE AVE STE 9A",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906214668",
            "telephone_number": "714-503-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "CAITLYN",
        "middle_name": "JEEIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-18",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95160347",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Sleep Medical Group, Inc.
• Pain Free, P.C.
• Pain MD Associates, Inc
• Pamela Pantiru, MSW
• Angela Park
• Chulhoon Park, L.AC.
• Ellen Sae Eun Park, N.P
• Euna Lim Park
• Eunice Park
• Eunsuk Park, L. AC

• Family Nurse Practitioner in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.