Glory Mental Health a Professional Nursing Corporation

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GLORY MENTAL HEALTH A PROFESSIONAL NURSING CORPORATION

Practice address

2501 E Chapman Ave Ste 106
Fullerton, CA 92831-3135

Phone

(805) 886-5200

NPI assigned

Oct 31, 2023

Organization subpart

No

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

Authorized official

Name

Juyeon ShinNPI 1093171696

Title

Ceo

Phone

(805) 886-5200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Juyeon Shin, NP

  • Nurse Practitioner
  • Palo Alto, CA
  • NPI 1093171696
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1619740859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 106",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 106",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313135",
            "telephone_number": "805-886-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORY MENTAL HEALTH A PROFESSIONAL NURSING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "JUYEON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "805-886-5200"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lena Totah Glasgow, PT, OCS
• Diane Lynn Gleeson, NP
• Allana E Glines-Bull, BA
• Global Dharma Medical Associates , Inc.
• Brian Ivan Gloriani
• Alicia M Glover, BCBA
• Rikki Renee Glover, COTA/L
• Tjoen Moi Go, PHARM D
• David Godinez
• Joanna Godinez

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.