Deisy Kim, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC18010 Issued in CA

Practice address

33122 Valle Rd
San Juan Capistrano, CA 92675-4859

Phone

(714) 794-9530

NPI assigned

Sep 23, 2019

Last updated

Jul 14, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Deisy Hernandez Cristobal Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amanecer Community Counseling Service, a Non-Profit Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Angeles, CA
  • NPI 1053449900
  NPD (past)

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1336790203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10536",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927110536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33122 VALLE RD",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926754859",
            "telephone_number": "714-794-9530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27125 Calle Arroyo",
            "address_purpose": "LOCATION",
            "city": "San Juan Capistrano",
            "state": "CA",
            "postal_code": "926752763",
            "country_code": "US",
            "telephone_number": "714-794-9530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DEISY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC18010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEISY",
            "last_name": "HERNANDEZ CRISTOBAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chet Khay, NP
• Kian Masoumi Rdhap Inc
• Clayton Eugene Kibler, MD, MMS
• Joseph Keith Kikumoto, O.D.
• Dan Hakjae Kim, D.C.
• Katharine Sujin Kim
• Michael Jong-Gyu Kim, D.D.S
• Bryan O King, M.D.
• Olutosin Kirya, DTR, CLT
• Tyler William Kisling, D.D.S.

• Mental Health Counselor in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.