Stella Kim, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35000 Issued in CA

Practice address

8616 La Tijera Blvd Ste 200
Los Angeles, CA 90045-3945

Phone

(310) 337-1550

Fax

(800) 549-4717

NPI assigned

Sep 19, 2012

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Well Mental Health Counseling Licensed Clinical Social Worker IncGroup PAC ID 6800244658, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Well Mental Health Counseling Licensed Clinical Social Worker Inc

  dba We Care Therapy Group

  • Mental Health Counselor
  • La Palma, CA
  • NPI 1942080981
  Medicare reassignment Care Compare group NPD
• Pacific Asian Counseling Services

  • Community/Behavioral Health Agency
  • Van Nuys, CA
  • NPI 1043412323
  NPD

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1659621415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CONCORD ST APT 105",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032817",
            "telephone_number": "562-858-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8616 LA TIJERA BLVD STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453945",
            "telephone_number": "310-337-1550",
            "fax_number": "800-549-4717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6931 Van Nuys Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914053996",
            "country_code": "US",
            "telephone_number": "818-989-9214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "STELLA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "94024164",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35000",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey R Kim
• Stacey Sooyeon Kim
• Stacy Kim
• Stan S Kim
• Stanley S. Kim, M.D.
• Stella Ki Kim, L.AC.
• Stephanie Kim, PSYD
• Stephanie Kim
• Stephanie Kim
• Stephanie Hyea-Jin Kim

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.