Ji Yun Nam, is a medicare enrolled "Psychologist - Clinical" provider in Lomita, California. Her current practice location is
2081 Palos Verdes Dr N, Lomita, California. You can reach out to her office (for appointments etc.) via phone at
(310) 325-6542.
Ji Yun Nam is licensed to practice in California (license number 31479) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982159349.
Healthcare Provider's Profile
| Full Name | Ji Yun Nam |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 2081 Palos Verdes Dr N, Lomita, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1982159349
- Provider Enumeration Date: 08/16/2016
- Last Update Date: 11/29/2021
Medicare PECOS Information:
- PECOS PAC ID: 1254748445
- Enrollment ID: I20210512003085
Medical Identifiers
Medical identifiers for Ji Yun Nam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1982159349 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 31479 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ji Yun Nam allows following entities to bill medicare on her behalf.
| Entity Name | Southern California Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770515280
PECOS PAC ID: 6002729175
Enrollment ID: O20031110000678 |
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| Entity Name | Orange Coast Psychological Associates Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679911085
PECOS PAC ID: 7810120599
Enrollment ID: O20140503000002 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ji Yun Nam is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ji Yun Nam,
2081 Palos Verdes Dr N,
Lomita, CA 90717-3701
Ph: (310) 325-6542 | Ji Yun Nam,
2081 Palos Verdes Dr N,
Lomita, CA 90717-3701
Ph: (310) 325-6542 |
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