Individual provider Active NPI

Namju Seong, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Orange, CA
National Provider Identifier
1174907158
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95002744 Issued in CA
Practice address
701 S Parker St Ste 2800
Orange, CA 92868-4720
Phone
(925) 282-1778
NPI assigned
Jul 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95002744 CA Primary

Addresses

Primary practice location

701 S Parker St Ste 2800
Orange, CA 92868-4720

Mailing address

701 S Parker St Ste 2800
Orange, CA 92868-4720

Other practice location 1

7212 Orangethorpe Ave Ste 9A
Buena Park, CA 90621-4668
Phone (714) 503-6550

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241016001634 CA Practitioner - Nurse Practitioner 6800328741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

701 S Parker St
Suite 2800
Orange, CA 92868-4720
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95002744CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Sep 9, 2024 Accepting new patients

Locations

4040 Barranca Pkwy
Ste 260
Irvine, CA 92604

701 S Parker St
Ste 2800
Orange, CA 92868

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

1450 10th St
Ste 404
Santa Monica, CA 90401
Phone (310) 451-8144

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.namjuseong@148377.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1174907158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S PARKER ST STE 2800",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S PARKER ST STE 2800",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684720",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7212 Orangethorpe Ave Ste 9A",
            "address_purpose": "LOCATION",
            "city": "Buena Park",
            "state": "CA",
            "postal_code": "906214668",
            "country_code": "US",
            "telephone_number": "714-503-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEONG",
        "first_name": "NAMJU",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95002744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.