Grace Kim

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

26795 Issued in CA

Practice address

3600 Wilshire Blvd Ste 2200
Los Angeles, CA 90010-2632

Phone

(213) 382-4400

NPI assigned

Feb 21, 2007

Last updated

Feb 27, 2020By 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 3

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, 2009

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Heritage Clinic and the Community Assistance Program for SeniorsGroup PAC ID 9032005798, 17 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.

• Heritage Clinic and the Community Assistance Program for Seniors

  dba Heritage Clinic Comm for Seniors

  • Clinical Psychologist
  • Pasadena, CA
  • NPI 1306899091
  Medicare reassignment Care Compare group NPD
• Heritage Senior Services

  • Counselor
  • Pasadena, CA
  • NPI 1932477932
  Medicare reassignment
• Oscar Oo, PSY.D.

  • Clinical Psychologist
  • Newport Beach, CA
  • NPI 1427128156
  Medicare reassignment
• Heritage Clinic and the Community Assistance Program for Seniors

  dba Heritage Los Angeles

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1093049546
  NPD
• Heritage Clinic and the Community Assistance Program for Seniors

  dba Heritage Clinic & Community Assistance Programs for Seniors

  • Clinical Psychologist
  • Long Beach, CA
  • NPI 1376681163
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1669507851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N EL MOLINO AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011403",
            "telephone_number": "626-577-8480",
            "fax_number": "626-577-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 WILSHIRE BLVD STE 2200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102632",
            "telephone_number": "213-382-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 N El Molino Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911011403",
            "country_code": "US",
            "telephone_number": "626-577-8480",
            "fax_number": "626-577-8978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "26795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Kim
• Gina Hyung-Jin Kim, FNP-C
• Gina J. Kim, M.D., MPH
• Gitae Kim, D.D.S.
• Grace Kim
• Grace Kim
• Grace H Kim, PHARMD
• Grace H Kim, PNP
• Grace Sang Kim, M.D.
• Grace Yaisol 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 Feb 27, 2020; 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.