GLORY MENTAL HEALTH A PROFESSIONAL NURSING CORPORATION
NPI 1619740859
Clinic/Center - Mental Health (Including Community Mental Health Center) in Fullerton, CA
About Glory Mental Health A Professional Nursing Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GLORY MENTAL HEALTH A PROFESSIONAL NURSING CORPORATION (NPI 1619740859) is a healthcare organization registered as a mental health (including community mental health center) in Fullerton, California and active in the NPI registry since October 2023. The organization lists Juyeon Shin, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Glory Mental Health A Professional Nursing Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Glory Mental Health A Professional Nursing Corporation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Glory Mental Health A Professional Nursing Corporation's NPI number?
The NPI number for Glory Mental Health A Professional Nursing Corporation is 1619740859. It was assigned to this organization in the NPPES registry on October 31, 2023.
Where is Glory Mental Health A Professional Nursing Corporation located?
Glory Mental Health A Professional Nursing Corporation is located at 2501 E Chapman Ave Ste 106, Fullerton, CA 92831. The listed phone number is (805) 886-5200.
What is Glory Mental Health A Professional Nursing Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Glory Mental Health A Professional Nursing Corporation enrolled in Medicare?
Yes. Glory Mental Health A Professional Nursing Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Glory Mental Health A Professional Nursing Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Glory Mental Health A Professional Nursing Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Glory Mental Health A Professional Nursing Corporation was last updated on May 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Glory Mental Health A Professional Nursing Corporation · NPI 1619740859
Mental Health (Including Community Mental Health Center) organization in Fullerton, California. Organization record, active in the CMS NPPES registry since October 31, 2023.
## Identity
- **NPI:** 1619740859 (Entity type: Organization)
- **Enumerated:** October 31, 2023
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Juyeon Shin, CEO
## Practice location
- **Address:** 2501 E CHAPMAN AVE STE 106, Fullerton, CA 92831-3135
- **Phone:** (805) 886-5200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 3, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1619740859) · Data from the CMS NPPES public registry.