Chan Sup Oh

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSB94029498 Issued in CA

Practice address

3555 Kenyon St Ste 101
San Diego, CA 92110-5341

Phone

(619) 600-0683

NPI assigned

Jul 1, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kevin Oh Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• The Family Guidance & Therapy Center of Southern California

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1780989301
  NPD (past)

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

{
    "created_epoch": "1782864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1194642181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KENYON ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105341",
            "telephone_number": "619-600-0683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 KENYON ST STE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105341",
            "telephone_number": "619-600-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OH",
        "first_name": "CHAN SUP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94029498",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-26-539950",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEVIN",
            "last_name": "OH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abimbola Ayodele Ogundeji, MFT
• Olufemi Olugboyega Ogungbe Jr.
• Anuoluwapo Ogunjumo
• Juliet Uju Oguno
• Anita Oh, MD
• Christine Oh
• Clarissa Oh
• Deborah Kyung Oh, MD
• Dennis Sangyun Oh
• Eunice Oh, OTR/L

• Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.