Individual provider Active NPI

Colleen Sun, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Rosemead, CA
National Provider Identifier
1447925912
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95018516 Issued in CA
Practice address
9353 Valley Blvd
Rosemead, CA 91770-1923
Phone
(626) 287-2988
NPI assigned
Aug 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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 NP95018516 CA Primary

Addresses

Primary practice location

9353 Valley Blvd
Rosemead, CA 91770-1923

Mailing address

415 W Route 66 Ste 202
Glendora, CA 91740-4335
Phone (626) 963-4467

Other practice location 1

2705 S Diamond Bar Blvd Ste 238
Diamond Bar, CA 91765-3554
Phone (909) 860-2166

Other practice location 2

415 W Route 66 Ste 202
Glendora, CA 91740-4335
Phone (626) 963-4467

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
I20220330000354 CA Practitioner - Nurse Practitioner 7911393061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific ClinicsGroup PAC ID 4082008420, 72 clinicians

Practice addresses (Care Compare)

1020 S Arroyo Pkwy
Pasadena, CA 91105-3911
Phone (626) 403-2794

1160 S Grand Ave
Glendora, CA 91740-5000
Phone (626) 335-5980

11741 Telegraph Rd
Suite Abandc
Santa Fe Springs, CA 90670-3681
Phone (562) 949-8455

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95018516CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics Current Accepting new patients
Pacific Clinics CurrentSince Mar 1, 2022 Accepting new patients
Pacific Clinics CurrentSince Mar 1, 2022 Accepting new patients

Locations

251 Llewellyn Ave
Campbell, CA 95008
Phone (408) 364-4083

1020 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 403-2794

9353 Valley Blvd
Rosemead, CA 91770
Phone (626) 287-2988

Interoperability endpoints

  • Direct secure messaging: colleen.sun.1@25478.direct.athenahealth.com

Organizations & group practices 3

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1447925912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W ROUTE 66 STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404335",
            "telephone_number": "626-963-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9353 VALLEY BLVD",
            "city": "ROSEMEAD",
            "state": "CA",
            "postal_code": "917701923",
            "telephone_number": "626-287-2988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2705 S Diamond Bar Blvd Ste 238",
            "address_purpose": "LOCATION",
            "city": "Diamond Bar",
            "state": "CA",
            "postal_code": "917653554",
            "country_code": "US",
            "telephone_number": "909-860-2166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 W Route 66 Ste 202",
            "address_purpose": "LOCATION",
            "city": "Glendora",
            "state": "CA",
            "postal_code": "917404335",
            "country_code": "US",
            "telephone_number": "626-963-4467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUN",
        "first_name": "COLLEEN",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95018516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemead, CA

Sources for this page

Verify at the official NPI Registry.