Jacqueline Kim, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

32623 Issued in CA

Practice address

101 The City Dr S
Orange, CA 92868-3201

Phone

(714) 456-8000

NPI assigned

Jul 17, 2013

Reactivated

Jun 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Hyo Ju Kim Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Michigan Medical School, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

UC RegentsGroup PAC ID 7416869516, 316 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uci Health-Orange Hospital, Orange, CA, CCN 050348

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• UC Regents

  • Infectious Disease Physician
  • Orange, CA
  • NPI 1760430847
  Medicare reassignment Care Compare group NPD
• UC Regents

  • Hematology & Oncology Physician
  • Orange, CA
  • NPI 1356399380
  NPD
• UC Regents

  • Pulmonary Disease Physician
  • Orange, CA
  • NPI 1629026729
  NPD
• UC Regents

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1205884392
  NPD (past)
• University of California Irvine

  • Infusion Therapy Clinic/Center
  • Irvine, CA
  • NPI 1417027475
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of California Irvine

  • Urgent Care Clinic/Center
  • Irvine, CA
  • NPI 1518739309

  Hospital

  Care Compare affiliation
• University of California Irvine

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1689608150
  Care Compare affiliation

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1487095501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JACQUELINE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "deactivation_date": "2021-05-28",
        "reactivation_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "32623",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "32623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HYO JU",
            "last_name": "KIM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heekyung Kim
• Hubert Doyoon Kim, M.D.
• Hyun Ok Kim, DDS
• Hyun-Jung Kim, D.D.S.
• Isis Kim
• Jae Hyeon Kim
• Jaehyun Kim, MD
• Jamie Jakyun Kim, LAC
• Jason Keechul Kim
• Jennifer Kim

• Psychologist in Orange, CA
• Providers in Orange, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.

Verify at the official NPI Registry.