DR. SOYON PARK PH.D.
NPI 1154562288
Psychologist in Belmont, CA

Active since March 19, 2009Opted out of Medicare · through Apr 1, 2028
3852 W NAUGHTON AVE, BELMONT, CA 94002(650) 520-0846 Get Directions Write a Review

NPPES record last updated: June 21, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Soyon Park Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SOYON PARK PH.D. (NPI 1154562288) is an individual psychologist in Belmont, California and active in the NPI registry since March 2009. She has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1154562288
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. SOYON PARKCredential: PH.D.
Location Address3852 W NAUGHTON AVEBelmont, CA 94002-1260
Mailing Address3852 W Naughton AveBelmont, CA 94002-1260 · (650) 520-0846 · Fax (650) 697-0350
Sole ProprietorYes
Enumeration DateMarch 19, 2009
Last NPPES UpdateJune 21, 2011
NPI 1154562288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
3852 W NAUGHTON AVE, Belmont, CA 94002

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Soyon Park Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2026 through April 1, 2028.

Opt-Out Effective DateApril 1, 2026
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Soyon Park's NPI number?

The NPI number for Soyon Park is 1154562288. It was assigned to this individual provider in the NPPES registry on March 19, 2009.

Where is Soyon Park located?

Soyon Park practices at 3852 W Naughton Ave, Belmont, CA 94002. The listed phone number is (650) 520-0846.

What is Soyon Park's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Soyon Park enrolled in Medicare?

No. Soyon Park has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Soyon Park was last updated on June 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.