Jiyoung Wittemore Kim

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT144043 Issued in CA

Practice address

18837 Brookhurst St Ste 102
Fountain Valley, CA 92708-7301

Phone

(562) 314-9890

Fax

(714) 699-1536

NPI assigned

Apr 4, 2024

Sex

Male

Sole proprietor

No

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

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 and National Provider Directory roles.

• Waves of Peace, an Individual and Family Counseling Corporation

  • Marriage & Family Therapist
  • Fountain Valley, CA
  • NPI 1326583279
  NPD (past)

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1437901113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 SHADOW OAKS",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926184096",
            "telephone_number": "626-344-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18837 BROOKHURST ST STE 102",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087301",
            "telephone_number": "562-314-9890",
            "fax_number": "714-699-1536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5855 E Naples Plz Ste 209",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908035080",
            "country_code": "US",
            "telephone_number": "562-314-9890",
            "fax_number": "714-699-1536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JIYOUNG",
        "middle_name": "WITTEMORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT144043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Chun Kim, DDS
• Chung Won Kim
• Ephraim Kim
• Jamie E Kim, M.D.
• Jeanie Lee Kim, WHNP
• Kenneth Kim, M.D
• Kirsten M Kim, PA-C
• Kristen Jane Kim
• Quy N Kim, DDS
• Stephanie Yonghee Kim, D.O.

• Marriage & Family Therapist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.