Active NPI
Sue Jeong
- Marriage & Family Therapist
- Pasadena, CA
National Provider Identifier
1487177879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 100282
- Practice address
- 236 W Mountain St Ste 202E
Pasadena, CA 91103-2969 - Phone
- (626) 808-5249
- NPI assigned
- Jul 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 100282 | CA | Primary |
Addresses
Primary practice location
236 W Mountain St Ste 202E
Pasadena, CA 91103-2969
Mailing address
1062 N Altadena Dr
Pasadena, CA 91107-1852
Phone (626) 808-5249
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240719003373 | CA | Practitioner - Marriage and Family Therapist | 2668918152 | Practice locations: Pasadena, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
236 W Mountain St
Suite 202E
Pasadena, CA 91103-2969
Phone (626) 808-5249
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1487177879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1062 N ALTADENA DR",
"city": "PASADENA",
"state": "CA",
"postal_code": "911071852",
"telephone_number": "626-808-5249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 W MOUNTAIN ST STE 202E",
"city": "PASADENA",
"state": "CA",
"postal_code": "911032969",
"telephone_number": "626-808-5249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEONG",
"first_name": "SUE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-18",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "100282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.