Jeesoon Park

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

532285 Issued in CA

Practice address

13300 Hawthorne Blvd
Hawthorne, CA 90250-5805

Phone

(424) 365-3031

NPI assigned

May 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706313600000",
    "number": "1740864370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12152 NAPOLI DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032773",
            "telephone_number": "310-402-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13300 HAWTHORNE BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505805",
            "telephone_number": "424-365-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEESOON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2024-01-27",
        "certification_date": "2024-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "95028679",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "532285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Panman, M.D.
• Irin Pansawira, O.D.
• Lorena Paoletti, L.AC.
• Robert Paoletti, D.P.M.
• Ruby V Paparello, L.M.F.T.
• Patricia Parker
• Caitlin Rose Parr, DPT,PT
• Eileen Parra, DDS
• Alicia Lavonne Partee, LMFT
• Pate & Ingam Home 2

• Psychiatric/Mental Health Registered Nurse in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2024; 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.