Individual provider Active NPI

Jyyeun Hong Kim

  • Mental Health Counselor
  • Santa Ana, CA
National Provider Identifier
1992351274
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
114710 Issued in CA
Practice address
3785 S Plaza Dr
Santa Ana, CA 92704-7463
Phone
(714) 828-2000
NPI assigned
Aug 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 114710 CA Primary

Addresses

Primary practice location

3785 S Plaza Dr
Santa Ana, CA 92704-7463

Mailing address

21 Abeto
Irvine, CA 92620-1802
Phone (949) 705-8626

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

LicenseStateTypeSpecialty
114710CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Straight Talk Clinic, Inc. CurrentSince Aug 18, 2019 Accepting new patients
Straight Talk Clinic, Inc. CurrentSince Jan 19, 2020 Accepting new patients

Locations

3785 S Plaza Dr
Santa Ana, CA 92704
Phone (714) 828-2000

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.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1992351274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ABETO",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926201802",
            "telephone_number": "949-705-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3785 S PLAZA DR",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047463",
            "telephone_number": "714-828-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JYYEUN",
        "middle_name": "HONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "114710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.