Active NPI
Sueyon Kim, CCC-SLP
- Speech-Language Pathologist
- Buena Park, CA
National Provider Identifier
1902428956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 27493
- Practice address
- 9550 Holder St
Buena Park, CA 90620-4209 - Phone
- (714) 236-3840
- NPI assigned
- May 13, 2020
- Last updated
- May 13, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 27493 | CA | Primary |
Addresses
Primary practice location
9550 Holder St
Buena Park, CA 90620-4209
Mailing address
17171 Bolsa Chica St Apt 37
Huntington Beach, CA 92649-5128
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sueyon.kim@savsd.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27493 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589328000000",
"number": "1902428956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17171 BOLSA CHICA ST APT 37",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926495128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9550 HOLDER ST",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906204209",
"telephone_number": "714-236-3840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUEYON",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-13",
"last_updated": "2020-05-13",
"certification_date": "2020-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "27493",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sueyon.kim@savsd.org",
"affiliation": "N",
"endpointDescription": "email",
"address_1": "9550 Holder St",
"city": "Buena Park",
"state": "CA",
"country_code": "US",
"postal_code": "906204209",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Buena Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.