So Yun Ahn
Individual provider Active NPI Family Nurse Practitioner · Visalia, CA
NPI 1306248703 · NPPES record last updated Apr 20, 2015
Key facts
- NPI
- 1306248703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- NP95000876 (CA)
- Practice address
- 627 S Garden St Apt C
Visalia, CA 93277-2851 - Phone
- (714) 581-3222
- NPI assigned
- Sep 17, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- SC Medical, Inc.
Practice addresses (Care Compare)
19042 Soledad Canyon Rd
Santa Clarita, CA 91351-3362
Phone (661) 251-6300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150805007696 | CA | Practitioner - Nurse Practitioner | 2365756202 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP95000876 | CA | MD | Family Nurse Practitioner |
Practice roles (6 of 7)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaweah Delta Health Care District | Current | Accepting new patients | |
| Kaweah Delta Health Care District | Current |
Accepting new patients | |
| SC Medical, Inc. | Current |
Accepting new patients | |
| SC Medical, Inc. | Current |
Accepting new patients | |
| Kaweah Delta Health Care District | Current |
Accepting new patients | |
| Kaweah Delta Health Care District | Current |
Accepting new patients |
Locations
19042 Soledad Canyon Rd
Santa Clarita, CA 91351
Phone (661) 251-6300
27550 Newhall Ranch Rd
Ste 203
Valencia, CA 91355
Phone (661) 251-6300
400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001
1633 S Court St
Visalia, CA 93277
Phone (559) 624-6090
840 S Akers St
Visalia, CA 93277
Phone (559) 624-3700
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP95000876 | CA | Yes |
Addresses
Primary practice location
627 S Garden St Apt C
Visalia, CA 93277-2851
Mailing address
627 S Garden St Apt C
Visalia, CA 93277-2851
Phone (714) 581-3222
Other providers in Visalia, CA
- Paola Aguirre
- Rosana Aguirre
- Sean D. Ahlmeyer
- Zahir Ahmad
- Mohammed Asfhan Ahmed
- Peter C. Aijian
- Benjamin Ainley
- Chinedu Innocent Akabike
- Fariba Akhavon
- Jeffrey Akin
All providers in Visalia, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.