Active NPI
Yewon Kim
- Student in an Organized Health Care Education/Training Program
- San Francisco, CA
National Provider Identifier
1366122079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3626 Balboa St
San Francisco, CA 94121-2604 - Phone
- (415) 668-5955
- NPI assigned
- Jul 19, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3626 Balboa St
San Francisco, CA 94121-2604
Mailing address
3626 Balboa St
San Francisco, CA 94121-2604
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1215 O St
Ms 3
Sacramento, CA 95814-5685
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
dba Coalinga State Hospital
- Psychiatric Hospital
- Coalinga, CA
- NPI 1124078704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1366122079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3626 BALBOA ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941212604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3626 BALBOA ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941212604",
"telephone_number": "415-668-5955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YEWON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.