John Park, PHD
NPI 1750632501ActiveIndividual· Psychologist, Clinical· Diamond Bar, CA
Psychologist, Clinical (PHD) in Diamond Bar, California, licensed in CA, with an NPI issued in September 2012.
Overview
| NPI | 1750632501 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | Yes |
| NPI issued | Sep 19, 2012 |
| Last updated in NPPES | Jul 27, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PSY30065 | CA |
| Psychologist | 103T00000X | 30065 | CA |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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