DR. KYONG H JO (PSY D) – Mental Health Counselor, NPI 1043334709

DR. KYONG H JO (PSY D) is a healthcare provider. based in Los angeles, California. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY D. They hold a License No. PSY32459 (CA). The NPI Number for DR. KYONG H JO (PSY D) is 1043334709

Main info

Male
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. KYONG H JO (PSY D)
NPI
1043334709
Phone
(323) 731-3534
Address
1665 W ADAMS BLVD
Enumeration Date
19 March 2007
Last Update Date
8 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3235256400
Graduation Year
2019 (7 years ago)
PAC ID
3971912064
Group Practice PAC ID
7416869896
Professional Enrollment ID
I20210430000958
Address ID
CA900443493LO8300XAVEX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,434 CLINICAL PSYCHOLOGIST in CA

Provider Addresses for DR. KYONG H JO (PSY D)

  • 1665 W ADAMS BLVD

    LOS ANGELES, CA 900071533

    Phone: (323) 731-3534

    Fax: (323) 731-5618

    Type: Mailing

  • 1847 SINALOA AVE

    PASADENA, CA 911041559

    Phone: (626) 720-7878

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-04-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210430000958IClinical PsychologistCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90832Psychotherapy, 30 minutes12414$0
View full utilization report →

Insurance plans in this area (ZIP 90007)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416869896View full group profile
NameSpecialtyState
P S Y C H I A T R YCA
Clinical Social WorkerCA
P S Y C H I A T R YCA
P S Y C H I A T R YCA
-CA
P S Y C H I A T R YCA
-CA
Clinical Social WorkerCA
Clinical Social WorkerCA
Psychiatry, Addiction MedicineCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. KYONG H JO (PSY D)?
DR. KYONG H JO (PSY D) — NPI 1043334709 — is the standard way to identify this listing.
Is DR. KYONG H JO (PSY D) still practicing?
DR. KYONG H JO (PSY D) is currently listed as active in the public NPI registry.
What taxonomy line describes DR. KYONG H JO (PSY D)?
For research purposes, treat DR. KYONG H JO (PSY D) as Mental Health Counselor in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. KYONG H JO (PSY D) on a map?
Expect Los Angeles, California as a primary anchor for DR. KYONG H JO (PSY D) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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