Ji Yun Nam

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31479 Issued in CA

Practice address

10061 Talbert Ave Ste 200
Fountain Valley, CA 92708-5123

Phone

(310) 845-6151

NPI assigned

Aug 16, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jiyun Nam Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Orange Coast Psychological Associates, P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fountain Valley, CA
  • NPI 1679911085

  Single Specialty

  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Harbor City, CA
  • NPI 1598797011
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280

  Single Specialty

  NPD

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1982159349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21143 HAWTHORNE BLVD # 241",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034615",
            "telephone_number": "310-845-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10061 TALBERT AVE STE 200",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085123",
            "telephone_number": "310-845-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "JI YUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JIYUN",
            "last_name": "NAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nahid Nasr MD Inc
• Bradley Najac
• Tomoko Nakamizo-Mukasa, M.A.
• Grace Harumi Nakamura, PA
• Gabriela Nakano
• Deepmala Nandanwar, M.D.
• Lisa Naruo
• Nahid Nasr, M.D.
• Pedram Nassi, PHARM D
• Natalie N. Pham, DDS Inc

• All providers in Fountain Valley, CA
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.