Active NPI
Jinae Su, M.D.
- Psychiatry Physician
- Rancho Cucamonga, CA
National Provider Identifier
1568490373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A068062
- Practice address
- 10750 4TH St
Rancho Cucamonga, CA 91730-0979 - Phone
- (900) 476-4456
- NPI assigned
- Jun 29, 2006
- Last updated
- Jun 15, 2026
- 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 | A068062 | CA | Primary |
Addresses
Primary practice location
10750 4TH St
Rancho Cucamonga, CA 91730-0979
Mailing address
10750 4TH St
Building 1 Office Suite 150
Rancho Cucamonga, CA 91730-0979
Phone (900) 476-4456
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A068062 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781481600000",
"number": "1568490373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10750 4TH ST",
"address_2": "BUILDING 1 OFFICE SUITE 150",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300979",
"telephone_number": "900-476-4456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10750 4TH ST",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300979",
"telephone_number": "900-476-4456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "JINAE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A068062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.