Ji Sung Jin

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A184471 Issued in CA

Practice address

900 University Ave
Riverside, CA 92521-3542

Phone

(951) 827-9197

Fax

(951) 827-7670

NPI assigned

Apr 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jjin305767@direct.llu.edu

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.

• Olive Crest

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1316101322
  NPD (past)

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1285254441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 UNIVERSITY AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925219800",
            "telephone_number": "951-827-9197",
            "fax_number": "951-827-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 UNIVERSITY AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925213542",
            "telephone_number": "951-827-9197",
            "fax_number": "951-827-7670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9990 County Farm Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033542",
            "country_code": "US",
            "telephone_number": "951-358-4700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Technology Ct Ste 300",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925072156",
            "country_code": "US",
            "telephone_number": "951-686-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIN",
        "first_name": "JI SUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A184471",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A184471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia Jimenez, MSW
• Jeanette Jimerson
• Jimmy Nguyen D.D.S., Inc
• Jin H Park DDS Inc
• Jane Jin, NONE
• Lizhong Jin
• Sung Jin, PHARMD
• Prateek Jindal, DO
• Salina M Jivan, OTD, OTR/L
• Jkim Nursing, Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.