Individual
CHRISTINE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4755 RASPBERRY PL, SAN JOSE, CA 95129-1936
(302) 442-3174
Mailing address
4755 RASPBERRY PL, SAN JOSE, CA 95129-1936
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3024423174
IDENTIFICATION
—
Enumeration date
04/07/2022
Last updated
04/07/2022
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