Soo Jung Lee, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A123814 Issued in CA

Practice address

11741 Telegraph Rd
Santa Fe Springs, CA 90670-3681

Phone

(652) 942-8256

NPI assigned

Jun 23, 2010

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: slee591742@direct.ochin.org

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.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Campbell, CA
  • NPI 1255496105
  Medicare reassignment Care Compare group NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1336458934
  NPD
• Pacific Clinics

  • Community/Behavioral Health Agency
  • West Covina, CA
  • NPI 1952069429
  NPD
• Wellspring Clinical Associates, Inc.

  • Psychiatry Physician
  • Lisle, IL
  • NPI 1164562609
  NPD (past)

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1295046498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 GENESEE DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605634114",
            "telephone_number": "847-254-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11741 TELEGRAPH RD",
            "city": "SANTA FE SPRINGS",
            "state": "CA",
            "postal_code": "906703681",
            "telephone_number": "652-942-8256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "251 Llewellyn Ave",
            "address_purpose": "LOCATION",
            "city": "Campbell",
            "state": "CA",
            "postal_code": "950081940",
            "country_code": "US",
            "telephone_number": "408-379-3790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Oak St Rm F-3",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951102817",
            "country_code": "US",
            "telephone_number": "408-295-3790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5950 Lincoln Ave Ste W",
            "address_purpose": "LOCATION",
            "city": "Lisle",
            "state": "IL",
            "postal_code": "605322613",
            "country_code": "US",
            "telephone_number": "630-541-8930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SOO",
        "middle_name": "JUNG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-132556",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A123814",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A123814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Lee
• Judy Lee
• Judy Lee, PH.D.
• Katherine Kim Lee, LCSW
• Michelle Lee
• Ye Ji Lee
• Jacquelyn Leeder
• Jessica Leon, LVN
• Jaslene Savanna Leos
• Darren Lewis

• Psychiatry Physician in Santa Fe Springs, CA
• Providers in Santa Fe Springs, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.

Verify at the official NPI Registry.