Kelly Soyong Yi, PSYCHOLOGIST

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 24210 Issued in CA

Practice address

4797 Telegraph Ave
Suite 203
Oakland, CA 94609-2007

Phone

(510) 698-2467

NPI assigned

May 25, 2009

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kelly.yi@direct.elationemr.com

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.

• The Mindful Center for Individual Couple and Family Therapy

  • Psychologist
  • Oakland, CA
  • NPI 1477995322
  NPD (past) Authorized official

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

{
    "created_epoch": "1243209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1831324524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4797 TELEGRAPH AVE",
            "address_2": "SUITE 203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092007",
            "telephone_number": "510-698-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4797 TELEGRAPH AVE",
            "address_2": "SUITE 203",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946092007",
            "telephone_number": "510-698-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "KELLY",
        "middle_name": "SOYONG",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-25",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 24210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shuk Ching Yeung
• Yvonne Yeung, M.D.
• Jovan D Yglecias, LMFT
• Loren Yglecias, FNP-C
• Cil Lee Yi
• Michael Yi
• Rosanne Yi
• Samuel Yihdego
• Selin Yildirgan, ED.S
• Susan H Yildizhan, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.