AMANDA KIM PSY.D.
NPI 1689050809
Psychologist - Clinical in Santa Ana, CA

Q: What is Amanda Kim's NPI number?

The NPI number for Amanda Kim is 1689050809. It was assigned to this individual provider in the NPPES registry on August 11, 2015.

Q: What is Amanda Kim's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Amanda Kim was last updated on September 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 11, 2015PECOS Enrolled

1560 BROOKHOLLOW DR STE 212, SANTA ANA, CA 92705(714) 386-9171 Get Directions Write a Review

NPPES record last updated: September 2, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 2, 2022, Aug 28, 2021 (2 updates tracked since 2021).

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About Amanda Kim Psy.d. NPPES

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

AMANDA KIM PSY.D. (NPI 1689050809) is an individual clinical provider in Santa Ana, California, licensed in California (33503) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Cypress, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1689050809

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameAMANDA KIMCredential: PSY.D.

Location Address1560 BROOKHOLLOW DR STE 212Santa Ana, CA 92705-5411

Mailing Address1560 Brookhollow Dr Ste 212Santa Ana, CA 92705-5411 · (714) 386-9171

Phone(714) 386-9171

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateAugust 11, 2015

Last NPPES UpdateSeptember 2, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 2, 2022

✔ NPI 1689050809 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 CA · 33503

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 ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X · License 33503 (CA)

Also ListedPsychologist · FamilyTaxonomy 103TF0000X · License 33503 (CA)

Also ListedPsychologist · Group PsychotherapyTaxonomy 103TP2701X · License 33503 (CA)

1560 BROOKHOLLOW DR STE 212, Santa Ana, CA 92705

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Secondary Practice Location 1

Location 19432 Alderbury StCypress, CA 90630-2850 · Phone (949) 444-9047

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Kim Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3870085343

PECOS Enrollment IDI20251121003113

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.

Medicare Billing Reassignment

Medicare enrollment records show Amanda Kim reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Meridian Counseling

41 mi

Marriage & Family Therapist

11835 W OLYMPIC BLVD STE 815E
Los Angeles, CA 90064

Reassigned Medicare billing, California enrollment
79 clinicians in this Medicare group

NPI 1396202206 (323) 332-9905

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92705 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

$187.60 typical visit price

range $62.96 – $187.60

Typical copayment $46.90 (range $15.74 – $46.90)

Most-billed visit code 99205

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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 2

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

JORDAN MARENDINO M.A.

Psychologist

1560 BROOKHOLLOW DR STE 212
SANTA ANA, CA 92705

Orange County (949) 242-9720

NOROOZ CLINIC FOUNDATION

Community/Behavioral Health

1560 BROOKHOLLOW DR STE 212
SANTA ANA, CA 92705

Orange County (949) 242-7920

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 Amanda Kim's NPI number?

The NPI number for Amanda Kim is 1689050809. It was assigned to this individual provider in the NPPES registry on August 11, 2015.

Where is Amanda Kim located?

Amanda Kim practices at 1560 Brookhollow Dr Ste 212, Santa Ana, CA 92705. The listed phone number is (714) 386-9171.

What is Amanda Kim's specialty?

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

Is Amanda Kim enrolled in Medicare?

Yes. Amanda Kim is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Amanda Kim's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Kim reassigns Medicare benefits to Meridian Counseling (Los Angeles, CA). The 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 Amanda Kim's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Amanda Kim was last updated on September 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.