Individual provider Active NPI

Da Yeon Kwon, LMFT

  • Marriage & Family Therapist
  • Cerritos, CA
National Provider Identifier
1548787922
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT153351 Issued in CA
Practice address
11050 Artesia Blvd Ste F
Cerritos, CA 90703-2542
Phone
(562) 860-8838
NPI assigned
Aug 25, 2017
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Marriage & Family Therapist 106H00000X NU
Marriage & Family Therapist 106H00000X LMFT153351 CA Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

11050 Artesia Blvd Ste F
Cerritos, CA 90703-2542

Mailing address

11050 Artesia Blvd Ste F
Cerritos, CA 90703-2542
Phone (562) 860-8838

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250521002023 CA Practitioner - Marriage and Family Therapist 9638698871 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT153351CAMDMarriage & Family Therapist
153351CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. CurrentSince Mar 6, 2025 Accepting new patients
Special Service for Groups, Inc. CurrentSince Mar 6, 2025 Accepting new patients

Locations

11050 Artesia Blvd
Ste F
Cerritos, CA 90703
Phone (562) 860-8838

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1548787922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 ARTESIA BLVD STE F",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032542",
            "telephone_number": "562-860-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 ARTESIA BLVD STE F",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032542",
            "telephone_number": "562-860-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "DA YEON",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT153351",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.