Jinah Kim Pak, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

81188 Issued in CA

Practice address

11050 Artesia Blvd Ste F
Cerritos, CA 90703-2542

Phone

(562) 860-8838

Fax

(213) 383-3146

NPI assigned

Jan 17, 2014

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 Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Special Service for Groups IncGroup PAC ID 2769396886, 61 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.

• Special Service for Groups, Inc.

  • Voluntary or Charitable Agency
  • Los Angeles, CA
  • NPI 1952442949
  Medicare reassignment Care Compare group NPD
• Special Service for Groups, Inc.

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1629424817
  NPD
• Special Service for Groups, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Los Angeles, CA
  • NPI 1982735932
  NPD

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

{
    "created_epoch": "1389916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1780006221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 ARTESIA BLVD STE F",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032542",
            "telephone_number": "562-860-8838",
            "fax_number": "213-383-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 ARTESIA BLVD STE F",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032542",
            "telephone_number": "562-860-8838",
            "fax_number": "213-383-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "JINAH",
        "middle_name": "KIM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-17",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "36711",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW36711",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "81188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Pahang
• Kanwarjit Pahwa, PH.D.
• Kiwoo Pai, PH.D
• Gina Wooyoung Paik, DDS
• Jaesoo Pak, M.D.
• Min Ji Pak
• Yoon Suk Pak, M.D.
• Paks Medical Clinic, Inc
• Dora Palacio
• Liliana Palacio, CASE MANAGER

• Clinical Social Worker in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.