Sangil Kwon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

29142 Issued in CA

Practice address

24511 W Jayne Ave
Coalinga, CA 93210-9503

Phone

(559) 935-4300

NPI assigned

Jul 15, 2017

Sex

Male

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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1500076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1790207231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7231 BOULDER AVE",
            "address_2": "STE 295",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463313",
            "telephone_number": "909-283-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24511 W JAYNE AVE",
            "city": "COALINGA",
            "state": "CA",
            "postal_code": "932109503",
            "telephone_number": "559-935-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "SANGIL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-15",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "29142",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021523",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Kolkebeck
• Emi Komaki
• Debra Lynn Kotler, PH.D.
• Dina Kristeva, NP
• Mark Kunze, PSY.D.
• Rebecca Jane Labbee
• Satyajeet Lahiri, MD
• Hung P Lam, DPM
• Niko Luna Laparan, PHARMD
• Giang Le, PHAMD

• Clinical Psychologist in Coalinga, CA
• Providers in Coalinga, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.