Roland Yongchul Kim, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17823 Issued in CA

Practice address

8345 Garden Grove Blvd
207
Garden Grove, CA 92844-1133

Phone

(714) 537-7070

NPI assigned

Mar 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417089863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10322",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928386322",
            "telephone_number": "213-804-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8345 GARDEN GROVE BLVD",
            "address_2": "207",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441133",
            "telephone_number": "714-537-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ROLAND",
        "middle_name": "YONGCHUL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nari Kim
• Peter Kim
• Rachel Kim, OD
• Richard Hyun-Jip Kim, DDS
• Rin Kim
• Sandy Soyon Kim, DDS
• Scott H Kim, PHARMD
• Seonhoon Sean Kim, D.C.
• Seung Hwan Kim, D.D.S
• Soo Kim, MS

• Clinical Psychologist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.