Active NPI
John Jyyoon Lee
- Psychiatric/Mental Health Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1841033305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95030505
- Practice address
- 11301 Wilshire Blvd. Building 402 (Mail Code 10H5)
Los Angeles, CA 90073 - Phone
- (310) 478-3711
- NPI assigned
- Jun 13, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95030505 | CA | Primary |
Addresses
Primary practice location
11301 Wilshire Blvd. Building 402 (Mail Code 10H5)
Los Angeles, CA 90073
Mailing address
11301 Wilshire Blvd. Building 402 (Mail Code 10H5)
Los Angeles, CA 90073
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: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1625 Schrader Blvd
Los Angeles, CA 90028-6213
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles LGBT Center | Current | Accepting new patients | |
| Los Angeles LGBT Center | Current | Accepting new patients |
Locations
1625 Schrader Blvd
Fl 3
Los Angeles, CA 90028
Phone (323) 993-7400
1625 Schrader Blvd
Los Angeles, CA 90028
Phone (323) 993-7400
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1548298532
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1225599178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718236800000",
"number": "1841033305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD. BUILDING 402 (MAIL CODE 10H5)",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD. BUILDING 402 (MAIL CODE 10H5)",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90073",
"telephone_number": "310-478-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOHN",
"middle_name": "JYYOON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-13",
"last_updated": "2024-06-13",
"certification_date": "2024-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95030505",
"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 Jun 13, 2024; 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.