Individual
JIYEON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
18107 SHERMAN WAY STE 200, RESEDA, CA 91335-8802
(818) 783-1002
Mailing address
18107 SHERMAN WAY STE 200, RESEDA, CA 91335-8802
(818) 783-1112
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95006590
CA
Other
Enumeration date
11/30/2018
Last updated
03/31/2022
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