Active NPI
Jae Yeun Kim, MD
- Psychiatry Physician
- San Mateo, CA
National Provider Identifier
1467245159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 20461
- Practice address
- 222 W 39TH Ave
San Mateo, CA 94403-4364 - Phone
- (650) 573-2222
- NPI assigned
- May 26, 2025
- Last updated
- Dec 10, 2025
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 20461 | CA | Primary |
Addresses
Primary practice location
222 W 39TH Ave
San Mateo, CA 94403-4364
Mailing address
2000 Alameda de Las Pulgas Ste 235
San Mateo, CA 94403-1185
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20461 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765324800000",
"number": "1467245159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 ALAMEDA DE LAS PULGAS STE 235",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944031185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 W 39TH AVE",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944034364",
"telephone_number": "650-573-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAE YEUN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-26",
"last_updated": "2025-12-10",
"certification_date": "2025-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "20461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.