DR. EUNICE KIM SONG PSY.D.
NPI 1811454267
Psychologist in San Mateo, CA

Active since February 21, 2019Opted out of Medicare · through Dec 29, 2027
177 BOVET RD STE 300, SAN MATEO, CA 94402(650) 627-1700 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 3, 2022, Feb 21, 2019 (2 updates tracked since 2019).

About Dr. Eunice Kim Song Psy.d. NPPES

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

DR. EUNICE KIM SONG PSY.D. (NPI 1811454267) is an individual psychologist in San Mateo, California, licensed in California (PSY30431) and active in the NPI registry since February 2019. She has opted out of Medicare through December 29, 2027.

NPPES Registry Identity

NPI1811454267
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. EUNICE KIM SONGCredential: PSY.D.
Location Address177 BOVET RD STE 300San Mateo, CA 94402-3140
Mailing Address177 Bovet Rd Ste 300San Mateo, CA 94402-3140
Sole ProprietorNo
Enumeration DateFebruary 21, 2019
Last NPPES UpdateJanuary 3, 20222 updates tracked since enumeration
NPI 1811454267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in CA · PSY30431
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

177 BOVET RD STE 300, San Mateo, CA 94402

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Eunice Kim Song Psy.d. 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 December 29, 2023 through December 29, 2027.

Opt-Out Effective DateDecember 29, 2023
Opt-Out In Effect ThroughDecember 29, 2027Opt-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.

Other Providers at the Same Location NPPES 5

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

Psychologist
177 BOVET RD STE 300
SAN MATEO, CA 94402
Psychologist (Clinical)
177 BOVET RD STE 300
SAN MATEO, CA 94402
Psychologist
177 BOVET RD STE 300
SAN MATEO, CA 94402
Psychiatry & Neurology (Psychiatry)
177 BOVET RD STE 300
SAN MATEO, CA 94402
Psychologist
177 BOVET RD STE 300
SAN MATEO, CA 94402

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 Eunice Song's NPI number?

The NPI number for Eunice Song is 1811454267. It was assigned to this individual provider in the NPPES registry on February 21, 2019.

Where is Eunice Song located?

Eunice Song practices at 177 Bovet Rd Ste 300, San Mateo, CA 94402. The listed phone number is (650) 627-1700.

What is Eunice Song's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Eunice Song enrolled in Medicare?

No. Eunice Song has opted out of Medicare through December 29, 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 Eunice Song was last updated on January 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.