Individual provider Active NPI

Kaelyn Heajin Yoo, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
National Provider Identifier
1316801756
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95037016 Issued in CA
Practice address
15819 Gramercy PL
Gardena, CA 90247-3609
Phone
(310) 283-1139
NPI assigned
Dec 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95037016 CA Primary

Addresses

Primary practice location

15819 Gramercy PL
Gardena, CA 90247-3609

Mailing address

15819 Gramercy PL
Gardena, CA 90247-3609
Phone (310) 283-1139

Other names 1

  • Heajin Yoo Other name

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260414001270 CA Practitioner - Nurse Practitioner 0648746032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1902 Wright PL
FL 2
Carlsbad, CA 92008-6583
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95037016CAMDPsychiatric/Mental Health Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1316801756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15819 GRAMERCY PL",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473609",
            "telephone_number": "310-283-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15819 GRAMERCY PL",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473609",
            "telephone_number": "310-283-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOO",
        "first_name": "KAELYN",
        "middle_name": "HEAJIN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95037016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEAJIN",
            "last_name": "YOO",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.