Individual provider Active NPI

Kim Bea Huynen, PHD

  • Clinical Psychologist
  • Cypress, CA
National Provider Identifier
1669701686
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 15010 Issued in CA
Practice address
5340 Myra Ave
Cypress, CA 90630-4569
Phone
(714) 828-6400
Fax
(714) 828-3400
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BCBA 1-00-0238 CA
Clinical Psychologist 103TC0700X PSY 15010 CA Primary

Addresses

Primary practice location

5340 Myra Ave
Cypress, CA 90630-4569

Mailing address

5340 Myra Ave
Cypress, CA 90630-4569
Phone (714) 828-6400

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 15010CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1669701686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 MYRA AVE",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304569",
            "telephone_number": "714-828-6400",
            "fax_number": "714-828-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 MYRA AVE",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906304569",
            "telephone_number": "714-828-6400",
            "fax_number": "714-828-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNEN",
        "first_name": "KIM",
        "middle_name": "BEA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "BCBA 1-00-0238",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 15010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cypress, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.