Active NPI
Jenny Kim
- Marriage & Family Therapist
- Chino Hills, CA
National Provider Identifier
1225806185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 15156 Canon LN
Chino Hills, CA 91709-5215 - Phone
- (909) 767-8971
- NPI assigned
- Dec 19, 2023
- Last updated
- Dec 19, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | NU | Primary |
Addresses
Primary practice location
15156 Canon LN
Chino Hills, CA 91709-5215
Mailing address
15156 Canon LN
Chino Hills, CA 91709-5215
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
15156 Canon LN
Chino Hills, CA 91709-5215
720 S B St
San Mateo, CA 94401-4245
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702944000000",
"number": "1225806185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15156 CANON LN",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917095215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15156 CANON LN",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917095215",
"telephone_number": "909-767-8971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JENNY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-19",
"last_updated": "2023-12-19",
"certification_date": "2023-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.