Individual provider Active NPI

Hae Lynn Kwon, MFT

  • Marriage & Family Therapist
  • Alpine, CA
National Provider Identifier
1790454627
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
157188 Issued in CA
Practice address
2271 Alpine Blvd Ste a
Alpine, CA 91901-1101
Phone
(888) 688-0248
NPI assigned
Sep 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X 135883 CA
Marriage & Family Therapist 106H00000X 157188 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2271 Alpine Blvd Ste a
Alpine, CA 91901-1101

Mailing address

2271 Alpine Blvd Ste a
Alpine, CA 91901-1101
Phone (888) 688-0248

Other practice location 1

1250 6th Ave Ste 100
San Diego, CA 92101-4368
Phone (619) 515-2430

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250912004085 CA Practitioner - Marriage and Family Therapist 6406359561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12970 Homestead PL
Chino, CA 91710-3390

2271 Alpine Blvd
Suite a
Alpine, CA 91901-1100

823 Gateway Ctr Way
San Diego, CA 92102-4541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
157188CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fusion Care Group, a Psychological Professional Corporation CurrentSince Aug 15, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Dec 1, 2025 Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Dec 1, 2025 Accepting new patients

Locations

2271 Alpine Blvd
Ste A
Alpine, CA 91901
Phone (619) 289-7322

2124 S El Camino Real
Ste 101
Oceanside, CA 92054
Phone (760) 405-4787

1250 6th Ave
Ste 100
San Diego, CA 92101
Phone (619) 515-2430

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1790454627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 ALPINE BLVD STE A",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011101",
            "telephone_number": "888-688-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2271 ALPINE BLVD STE A",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919011101",
            "telephone_number": "888-688-0248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 6th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921014368",
            "country_code": "US",
            "telephone_number": "619-515-2430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWON",
        "first_name": "HAE",
        "middle_name": "LYNN",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "135883",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "157188",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpine, CA

Sources for this page

Verify at the official NPI Registry.