Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

YEONJU NAM
NPI 1619577699
Physical Therapist in San Diego, CA

Active since October 28, 2020
11717 SORRENTO VALLEY RD, SAN DIEGO, CA 92121(858) 847-2025 Get Directions Write a Review

NPPES record last updated: September 24, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 24, 2026, Nov 21, 2025, Oct 28, 2020 (3 updates tracked since 2020).

About Yeonju Nam NPPES

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

YEONJU NAM (NPI 1619577699) is an individual physical therapist in San Diego, California, licensed in California (PT306065) and active in the NPI registry since October 2020. She is a graduate of Other (2021).

NPPES Registry Identity

NPI1619577699
Entity TypeIndividualFemale
Primary Taxonomy225100000X
Provider Legal NameYEONJU NAM
Location Address11717 SORRENTO VALLEY RDSan Diego, CA 92121-1004
Mailing Address11717 Sorrento Valley RdSan Diego, CA 92121-1004 · (858) 847-2025
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 28, 2020
Last NPPES UpdateSeptember 24, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 24, 2026
✔ NPI 1619577699 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225100000X
Licenses✔ Licensed in CA · PT306065✔ Licensed in NY · 040982
Definition
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.
11717 SORRENTO VALLEY RD, San Diego, CA 92121

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

Yeonju Nam 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 ID1355835026
PECOS Enrollment IDI20251210001699

Other Providers at the Same Location NPPES 2

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

Physical Therapist
11717 SORRENTO VALLEY RD
SAN DIEGO, CA 92121
Physical Therapist
11717 SORRENTO VALLEY RD
SAN DIEGO, CA 92121

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 Yeonju Nam's NPI number?

The NPI number for Yeonju Nam is 1619577699. It was assigned to this individual provider in the NPPES registry on October 28, 2020.

Where is Yeonju Nam located?

Yeonju Nam practices at 11717 Sorrento Valley Rd, San Diego, CA 92121. The listed phone number is (858) 847-2025.

What is Yeonju Nam's specialty?

The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.

Is Yeonju Nam enrolled in Medicare?

Yes. Yeonju Nam 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 Yeonju Nam was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.