Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1124582887 Deactivated / Inactive NPI Female Practitioner

Yena Kim

Speech-Language Pathologist • La Mirada, CA

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Yena Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 28, 2019
NPI Deactivation Date October 16, 2023
Total Practice Duration ~1 Years of Practice (2022 – 2023)

Professional Overview & Biography Verified Profile Summary

Yena Kim was a registered Speech-Language Pathologist practicing in La Mirada, CA. Throughout an active medical career spanning 1 years, Yena Kim provided care at the practice location at 15242 MATISSE CIR until profile deactivation on 2023-10-16.

Yena Kim did not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

15242 Matisse Cir

La Mirada, CA 906384731

Telephone 7144037988

Medicare Profile & Education

Medical School

Other

Graduation Year

2022

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in La Mirada, CA

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
4 Yrs Matches City Avg
City Avg: 4.0 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
2 Specialists

Practicing in La Mirada, CA (13280 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kim (4 Years) 4 Yrs
La Mirada Specialty Average (4.0 Years) 4.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-01-30
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA22038

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location January 30, 2024

Registered at 15242 MATISSE CIR, LA MIRADA, CA 906384731 (Tel: 7144037988)

📍
Updated Business Mailing Address January 30, 2024

Registered at 18946 N DALE MABRY HWY, LUTZ, FL 335484900

👤
Provider Name / Credentials Updated January 30, 2024

Recorded as YENA KIM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2024

Speech-Language Pathologist (License #SA22038 in FL)

⚠️
NPI Profile Deactivated October 16, 2023

Record deactivated on October 16, 2023

NPI Profile Active January 28, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location January 28, 2019

Registered at 15242 MATISSE CIR, LA MIRADA, CA 906384731 (Tel: 7144037988)

📍
Updated Business Mailing Address January 28, 2019

Registered at 15242 MATISSE CIR, LA MIRADA, CA 906384731

👤
Provider Name / Credentials Updated January 28, 2019

Recorded as YENA KIM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 28, 2019

Specialist/Technologist (License #5282 in CA)

🟢
Initial NPI Registration & Enumeration January 28, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Yena Kim. Be the first to share your experience!

Sign in to leave a review for Yena Kim

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1124582887
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 28, 2019
Last Update: January 30, 2024
Deactivation Date: October 16, 2023
Sole Proprietor: No

Mailing Address

18946 N Dale Mabry Hwy

Lutz, FL 335484900

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.