Mary Ann Yaeil Kim, PH.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

PSY10504 Issued in CA

Practice address

465 California St Ste 630
San Francisco, CA 94104-1845

Phone

(415) 905-9680

NPI assigned

Sep 25, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1700437217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 MILLER AVE # 472",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411927",
            "telephone_number": "415-905-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 CALIFORNIA ST STE 630",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941041845",
            "telephone_number": "415-905-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MARY ANN",
        "middle_name": "YAEIL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY10504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "yaeilkim@gmail.com",
            "affiliation": "N",
            "address_1": "465 California St Ste 630",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941041845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyung-Hwa Kim, CNC
• Lana Kim
• Lauren Taylor Kim, PHYSICIAN ASSISTANT
• Lena H. Kim, MD
• Marie Ruth J Kim, LVN
• Mee Kyung Kim, RPH
• Megan Miji Kim, MD
• Melody C Kim, MD
• Michael Gee Hoon Kim
• Mindy Minjeong Kim, MD

• Forensic Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Forensic Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.