Individual
EUNICE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11911 SAN VICENTE BLVD STE 280, LOS ANGELES, CA 90049-6611
(310) 740-0214
(310) 882-6807
Mailing address
PO BOX 25852, LOS ANGELES, CA 90025-0852
(310) 740-0214
(310) 882-6807
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY21462
CA
103TC0700X
Clinical Psychologist
PSY21462
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY214620
—
CA
Enumeration date
07/08/2009
Last updated
05/04/2012
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