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ROY KIM
NPI 1508214289
Marriage & Family Therapist in Diamond Bar, CA

Active since June 02, 2016Opted out of Medicare · through Jan 1, 2028
1360 VALLEY VISTA DR STE 207, DIAMOND BAR, CA 91765(408) 676-9546 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Jan 10, 2020 (2 updates tracked since 2020).

About Roy Kim NPPES

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

ROY KIM (NPI 1508214289) is an individual marriage & family therapist in Diamond Bar, California, licensed in California (MFT82450) and active in the NPI registry since June 2016. He has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1508214289
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameROY KIM
Location Address1360 VALLEY VISTA DR STE 207Diamond Bar, CA 91765-3953
Mailing Address1360 Valley Vista Dr Ste 207Diamond Bar, CA 91765-3953 · (408) 676-9546
Phone(408) 676-9546
Sole ProprietorYes
Enumeration DateJune 2, 2016
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 10, 2020
✔ NPI 1508214289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · MFT82450
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1360 VALLEY VISTA DR STE 207, Diamond Bar, CA 91765
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Roy Kim 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 January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Roy Kim's NPI number?

The NPI number for Roy Kim is 1508214289. It was assigned to this individual provider in the NPPES registry on June 2, 2016.

Where is Roy Kim located?

Roy Kim practices at 1360 Valley Vista Dr Ste 207, Diamond Bar, CA 91765. The listed phone number is (408) 676-9546.

What is Roy Kim's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Roy Kim enrolled in Medicare?

No. Roy Kim has opted out of Medicare through January 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 Roy Kim was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.