Jiwon Helen Wyman, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A159214 Issued in CA

Practice address

1918 Bonita Ave # 208
Berkeley, CA 94704-1014

Phone

(714) 410-6516

NPI assigned

May 3, 2017

Last updated

Mar 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Jiwon Helen Shin Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of California, Irvine, California College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Agnes Medical CenterGroup PAC ID 3971409335, 45 clinicians

Rideout Memorial HospitalGroup PAC ID 9234036088, 88 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rideout Memorial Hospital

  dba Adventist Health and Rideout

  • General Acute Care Hospital
  • Marysville, CA
  • NPI 1720088354
  Medicare reassignment Care Compare group NPD
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Medicare reassignment Care Compare group NPD
• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Santa Maria, CA
  • NPI 1538757232
  Medicare reassignment NPD
• Bay Psychiatric Associates

  • Psychiatry Physician
  • Berkeley, CA
  • NPI 1427163229
  Medicare reassignment
• Jiwon Helen Wyman MD PC

  • Adult Mental Health Clinic/Center
  • Irvine, CA
  • NPI 1265034839
  Authorized official Same address or phone
• Cep America - Psychiatry PC

  • Psychiatry Physician
  • Indio, CA
  • NPI 1144195926
  NPD
• Cep America - Psychiatry PC

  • Psychiatry Physician
  • San Mateo, CA
  • NPI 1396435921
  NPD
• Trinity Home Health Services

  dba Saint Agnes Home Health and Hospice, LLC

  • Community Based Hospice Care Agency
  • Fresno, CA
  • NPI 1750478293
  NPD
• Optum Behavioral Care of California, P.C.

  • Clinical Psychologist
  • San Francisco, CA
  • NPI 1053172833
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567
  Care Compare affiliation

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1043746621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 LAS GALLINAS AVE # 2030",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033618",
            "telephone_number": "714-410-6516",
            "fax_number": "714-274-7568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 BONITA AVE # 208",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041014",
            "telephone_number": "714-410-6516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16824 44th Ave W Ste 170",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980373117",
            "country_code": "US",
            "telephone_number": "714-410-6516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYMAN",
        "first_name": "JIWON HELEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61425994",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A159214",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD61425994",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A159214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIWON",
            "last_name": "SHIN",
            "middle_name": "HELEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Serena Wu, MD
• Stanley Solomon Wulf, M.D.
• Diane Lomas Wyatt, L.M.F.T.
• Takeyah Wyche
• Jennifer Wydro, PSY.D.
• Jenny Xing
• Wenxu Xu, MA
• Lawrence Jonas Yabroff, PH.D.
• Deborah M Yaffe, MFT
• Janet Yamada Soto, PT

• Psychiatry Physician in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.