Active NPI
John Kim, MA MFT
- Marriage & Family Therapist
- Pasadena, CA
National Provider Identifier
1083071716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT105035
- Practice address
- 572 E Green St Ste 304
Pasadena, CA 91101-2085 - Phone
- (424) 257-7394
- NPI assigned
- Jan 26, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LMFT105035 | CA | Primary |
Addresses
Primary practice location
572 E Green St Ste 304
Pasadena, CA 91101-2085
Mailing address
280 E del Mar Blvd Apt 208
Pasadena, CA 91101-2738
Phone (424) 257-7394
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT105035 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Marriage & Family Therapist | Current | Accepting new patients |
Interoperability endpoints
- johnkim@tdh.allscriptsdirect.net
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Marriage & Family Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1083071716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 E DEL MAR BLVD APT 208",
"city": "PASADENA",
"state": "CA",
"postal_code": "911012738",
"telephone_number": "424-257-7394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "572 E GREEN ST STE 304",
"city": "PASADENA",
"state": "CA",
"postal_code": "911012085",
"telephone_number": "424-257-7394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "MA MFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-01-26",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT105035",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.