Individual
NELLIE HYUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.A.
Contact information
Practice address
1533 EUCLID ST, SANTA MONICA, CA 90404-3306
(310) 452-3325
Mailing address
9632 PASO ROBLES AVE, NORTHRIDGE, CA 91325-1964
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-1647832
TAX ID
CA
Enumeration date
08/02/2010
Last updated
08/02/2010
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