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JUDY JOOEUN PARK
NPI 1336978170
Nurse Practitioner - Psychiatric/Mental Health in San Diego, CA

Active since July 30, 2024PECOS EnrolledAccepts Medicare Assignment
200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 25, 2024, Jul 30, 2024 (2 updates tracked since 2024).

About Judy Jooeun Park NPPES

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

JUDY JOOEUN PARK (NPI 1336978170) is an individual psychiatric/mental health provider in San Diego, California, licensed in California (95030661) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS, maintains 5 additional practice locations, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1336978170
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJUDY JOOEUN PARK
Location Address200 W ARBOR DRSan Diego, CA 92103-9000
Mailing AddressFile 57326Los Angeles, CA 90074-0001
Phone(800) 926-8273
Fax(888) 539-8781
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 30, 2024
Last NPPES UpdateSeptember 25, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 25, 2024
✔ NPI 1336978170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95030661
200 W ARBOR DR, San Diego, CA 92103
Open in Google Maps ↗

Secondary Practice Locations 5

Location 11509 Wilson TerGlendale, CA 91206-4007 · Phone (818) 409-8063
Location 26645 Alvarado RdSan Diego, CA 92120-5208 · Phone (800) 926-8273 · Fax (888) 539-8781
Location 36655 Alvarado RdSan Diego, CA 92120-5208 · Phone (800) 926-8273 · Fax (888) 539-8781
Location 4350 Dickinson StSan Diego, CA 92103-1913 · Phone (800) 926-8273 · Fax (888) 539-8781
Location 56363 Greenwich DrSan Diego, CA 92122-5947 · Phone (800) 926-8273 · Fax (888) 539-8781

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Judy Jooeun Park is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759812548
PECOS Enrollment IDI20241003002923
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RAMIN MOTARJEMI M.D.
Internal Medicine (Geriatric Medicine)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (858) 249-2500
DR. KYLE PALMER EDMONDS M.D., FAAHPM
Hospice, Inpatient
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
SHAWN RAVEENTH VEDAMANI MD
Anesthesiology
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
DALE MICHAEL TRUJILLO NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
KAYLEE PETERSEN ARNP
Nurse Practitioner (Psychiatric/Mental Health)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
IRENE NEVAREZ NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
WILLIAM JAMES MOSS M.D.
Student in an Organized Health Care Education/Training Program
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (508) 395-4189
JAMES HAMILTON JR. PA-C
Physician Assistant (Surgical)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (858) 657-8200

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 Judy Park's NPI number?

The NPI number for Judy Park is 1336978170. It was assigned to this individual provider in the NPPES registry on July 30, 2024.

Where is Judy Park located?

Judy Park practices at 200 W Arbor Dr, San Diego, CA 92103. The listed phone number is (800) 926-8273.

What is Judy Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Judy Park enrolled in Medicare?

Yes. Judy Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Judy Park was last updated on September 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.