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MISS JESSICA K KIM PSYD
NPI 1679978589
Psychologist - Clinical in Seattle, WA

Active since November 04, 2014Opted out of Medicare · through Jun 28, 2027
200 W MERCER ST # E305, SEATTLE, WA 98119(206) 589-1018 Get Directions Write a Review

NPPES record last updated: March 14, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Miss Jessica K Kim Psyd NPPES

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

MISS JESSICA K KIM PSYD (NPI 1679978589) is an individual clinical provider in Seattle, Washington, licensed in Washington (PSY61320770) and active in the NPI registry since November 2014. She has opted out of Medicare through June 28, 2027 and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1679978589
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameMISS JESSICA K KIMCredential: PSYD
Location Address200 W MERCER ST # E305Seattle, WA 98119-3995
Mailing Address21081 S Western Ave Ste 295Torrance, CA 90501-1707 · (310) 533-6600
Phone(206) 589-1018
Sole ProprietorNo
Enumeration DateNovember 4, 2014
Last NPPES UpdateMarch 14, 2024
NPPES CertifiedMarch 14, 2024
✔ NPI 1679978589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in WA · PSY61320770
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
200 W MERCER ST # E305, Seattle, WA 98119
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Secondary Practice Locations 2

Location 121081 S Western Ave Ste 295Torrance, CA 90501-1707 · Phone (310) 533-6600
Location 24335 Atlantic AveLong Beach, CA 90807-2803 · Phone (562) 219-4900

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Miss Jessica K Kim Psyd 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 June 28, 2023 through June 28, 2027.

Opt-Out Effective DateJune 28, 2023
Opt-Out In Effect ThroughJune 28, 2027Opt-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 Jessica Kim's NPI number?

The NPI number for Jessica Kim is 1679978589. It was assigned to this individual provider in the NPPES registry on November 4, 2014.

Where is Jessica Kim located?

Jessica Kim practices at 200 W Mercer St # E305, Seattle, WA 98119. The listed phone number is (206) 589-1018.

What is Jessica Kim's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jessica Kim enrolled in Medicare?

No. Jessica Kim has opted out of Medicare through June 28, 2027. 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 Jessica Kim was last updated on March 14, 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.