Kyong H Jo, PSY D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY32459 Issued in CA

Practice address

1847 Sinaloa Ave
Pasadena, CA 91104-1559

Phone

(626) 720-7878

Fax

(626) 316-6780

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kyong H Jo Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Well Mental Health Counseling Licensed Clinical Social Worker IncGroup PAC ID 6800244658, 9 clinicians

Los Angeles County Department of Mental HealthGroup PAC ID 7416869896, 294 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1083633929
  Medicare reassignment Care Compare group NPD
• Well Mental Health Counseling Licensed Clinical Social Worker Inc

  • Mental Health Counselor
  • La Palma, CA
  • NPI 1942080981
  Medicare reassignment Care Compare group NPD
• Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1477737534
  NPD
• Los Angeles County Department of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Arcadia, CA
  • NPI 1902676075
  NPD
• Carrie Horn and Associates Psychological Corporation

  • Community/Behavioral Health Agency
  • South Pasadena, CA
  • NPI 1487078820
  NPD (past)
• TMH Psychotherapy Corporation

  • Clinical Psychologist
  • Sherman Oaks, CA
  • NPI 1225563752
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1043334709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 SINALOA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041559",
            "telephone_number": "626-720-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 SINALOA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911041559",
            "telephone_number": "626-720-7878",
            "fax_number": "626-316-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JO",
        "first_name": "KYONG",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYONG",
            "last_name": "JO",
            "middle_name": "H",
            "credential": "PSY D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph Jin
• Tian Jin, DDS
• Rina Jindal, D.D.S.
• JKM Therapy Corp
• Raine Lynn Jo-Fung
• Mark Jeffrey Jo, MD
• Joanne E. Casserly, Licensed Clinical Social Worker, Inc.
• Diana Teresa Joaquin
• Joel W Heger MD, Inc.
• Johanna Olson-Kennedy Apmc

• Clinical Psychologist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.