Active NPI
Rachel Shinae Kang
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1831615806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 90594
- Practice address
- 3200 Motor Ave
Los Angeles, CA 90034-3740 - Phone
- (310) 836-1223
- NPI assigned
- Aug 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ASW90594 | CA | |
| Mental Health Counselor | 101YM0800X | 90594 | CA | Primary |
Addresses
Primary practice location
3200 Motor Ave
Los Angeles, CA 90034-3740
Mailing address
3200 Motor Ave
Los Angeles, CA 90034-3740
Phone (310) 836-1223
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 29, 2024 through Jan 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW90594 | CA | MD | Clinical Social Worker |
| 90594 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611273600000",
"number": "1831615806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 MOTOR AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343740",
"telephone_number": "310-836-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 MOTOR AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343740",
"telephone_number": "310-836-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "RACHEL",
"middle_name": "SHINAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-21",
"last_updated": "2021-01-22",
"certification_date": "2021-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "ASW90594",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "90594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.