Shannon Choi Kim

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

103817 Issued in CA

Practice address

4000 W Metropolitan Dr Ste 120
Orange, CA 92868-3504

Phone

(714) 972-3700

NPI assigned

Feb 5, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Marriage and Family Therapist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of OrangeGroup PAC ID 1951215789, 45 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 and National Provider Directory roles.

• County of Orange

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Ana, CA
  • NPI 1104963347
  Medicare reassignment Care Compare group NPD
• Jona Licensed Clinical Social Worker PC

  • Clinical Social Worker
  • Fullerton, CA
  • NPI 1932910825

  Marriage & Family Therapist

  Medicare reassignment NPD
• County of Orange

  • Adult Mental Health Clinic/Center
  • Santa Ana, CA
  • NPI 1598025793
  NPD
• KCS, Inc.

  • Community/Behavioral Health Agency
  • Buena Park, CA
  • NPI 1104484344
  NPD (past)
• Orange County Asian & Pacific Islander Community Alliance

  • Community/Behavioral Health Agency
  • Garden Grove, CA
  • NPI 1730323585
  NPD (past)

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1760873236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR # 120",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-972-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W METROPOLITAN DR STE 120",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683504",
            "telephone_number": "714-972-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SHANNON",
        "middle_name": "CHOI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "103817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reina Nae Kim, NP
• Robin Am Kim, M.D.
• Sarah Sueyeon Kim, MD
• Sein Kim, BEHAVIOR TECHNICIAN
• Seon Nam Kim, L.AC., D.A.O.M.
• Sharon Kim, MD
• Shelby Kim
• Simon Kim, BA, MD
• Soo Yeon Kim, MD
• Soomin Kim, CRNA

• Marriage & Family Therapist in Orange, CA
• Providers in Orange, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.