Active NPI
Soojung Yoo, NP
- Family Nurse Practitioner
- Roseburg, OR
National Provider Identifier
1295406502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 10056027
- Practice address
- 913 NW Garden Valley Blvd
Roseburg, OR 97471-6523 - Phone
- (541) 440-1000
- NPI assigned
- Sep 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95106752 | CA | |
| Family Nurse Practitioner | 363LF0000X | 95021611 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95021611 | CA | |
| Family Nurse Practitioner | 363LF0000X | 10056027 | OR | Primary |
| Registered Nurse | 163W00000X | 10056027 | OR |
Addresses
Primary practice location
913 NW Garden Valley Blvd
Roseburg, OR 97471-6523
Mailing address
913 NW Garden Valley Blvd
Roseburg, OR 97471-6523
Phone (541) 440-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95106752 | CA | MD | Registered Nurse |
| 10056027 | OR | MD | Registered Nurse |
| 95021611 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Metropolitan Detention Center Los Angeles | Current | Accepting new patients | |
| Usc Care Medical Group, Inc | Past | Accepting new patients | |
| Jason S Paek MD,Inc | Past | Accepting new patients |
Locations
535 N Alameda St
Los Angeles, CA 90012
Phone (213) 485-0439
Organizations & group practices 3
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.
-
- Prison Health Clinic/Center
- Los Angeles, CA
- NPI 1144050097
-
- Internal Medicine Physician
- Rowland Heights, CA
- NPI 1205392602
-
- General Practice Physician
- Los Angeles, CA
- NPI 1902846306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1295406502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "913 NW GARDEN VALLEY BLVD",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974716523",
"telephone_number": "541-440-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "913 NW GARDEN VALLEY BLVD",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974716523",
"telephone_number": "541-440-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOO",
"first_name": "SOOJUNG",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-26",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95106752",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95021611",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95021611",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OR",
"license": "10056027",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OR",
"license": "10056027",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.