KELLY KIM (NPI# 1154987790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154987790 |
| Entity Type | Individual |
| Full Name | KELLY KIM |
| Practice Address |
329 Eucalyptus Dr Apt C El Segundo CA 90245-4252 |
| Practice Telephone | 3104027370 |
| Enumeration Date | 2019-05-18 |
| Last Update Date | 2019-05-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | R1335190119 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760816607 | Kelly Heejung Kim | Dentist | 26742 E. University Dr., Building 200, Suite 220, Aubrey, TX 76227 | 2013-08-28 |
| 1750692505 | Kelly Kyunghee Kim | Occupational Therapist | 3237 34th St, Astoria, NY 11106-1801 | 2010-06-27 |
| 1861724403 | Kelly Kim | Pharmacist | 272 Shadow Mountain Dr, Apt 41, El Paso, TX 79912-4756 | 2010-02-08 |
| 1255959904 | Kelly Marie Kim | Pharmacist | 5125 Jonestown Rd, Harrisburg, PA 17112-2990 | 2020-07-09 |
| 1447882592 | Kelly Baek Kim | Occupational Therapy Assistant | 7320 Firestone Blvd Ste 105, Downey, CA 90241-4159 | 2020-02-06 |
| 1558845487 | Kelly Anne Kim | Nurse Practitioner | 1975 4th St, San Francisco, CA 94143-2351 | 2018-09-17 |
| 1285031427 | Kelly Kim | Pharmacist | 6301 York Rd, Baltimore, MD 21212-2636 | 2014-12-03 |
| 1053625715 | Kelly Yeon Su Kim | Dentist | 30001 Crown Valley Pkwy, Suite G, Laguna Niguel, CA 92677-1723 | 2010-08-04 |
| 1104065523 | Kelly Eunjoo Kim | Acupuncturist | 280 Newport Center Dr, Suite 200, Newport Beach, CA 92660-7526 | 2009-02-09 |
| 1912089244 | Kelly H. C. Kim | Nurse Practitioner | 1708 Old Donation Pkwy, Virginia Beach, VA 23454-3064 | 2006-10-19 |
| Street Address |
329 EUCALYPTUS DR APT C |
| City | EL SEGUNDO |
| State | CA |
| Zip Code | 90245-4252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366058976 | Britt'nee Cornelius | Massage Therapist | 222 North PCh, Suite 2000, El Segundo, CA 90245 | 2020-09-18 |
| 1750913778 | Laurie Ann Scoppetto | Dietitian, Registered | 482 N Aviation Blvd, El Segundo, CA 90245 | 2020-02-07 |
| 1972135283 | A Dabrowska Dds, Inc | Dentist | 390 N. Pacific Coast Hwy #1050, El Segundo, CA 90245 | 2020-02-05 |
| 1578023057 | Miles Bertumen | Pharmacist | 283 N Aviation Blvd, Building 210, El Segundo, CA 90245 | 2019-03-21 |
| 1831673201 | Kriss L. Killam | Marriage & Family Therapist | 302 W. Grand Ave., Suite 9, El Segundo, CA 90245 | 2018-09-20 |
| 1811487911 | Bright Light Recovery | Substance Abuse Rehabilitation Facility | 218 Concord St, Suite C, El Segundo, CA 90245 | 2018-05-14 |
| 1265950448 | Sarah Yuriko Mizuki | Physician Assistant | 390 N PCh, Suite 1000, El Segundo, CA 90245 | 2017-09-07 |
| 1326586462 | Jlp Interpreting Services | Interpreter | 963 Virginia St #5, El Segundo, CA 90245 | 2017-02-09 |
| 1619351707 | El Segundo Dermatology, Inc. | Specialist | 713 N Douglas St., El Segundo, CA 90245 | 2015-07-17 |
| 1083956635 | 24hr Homecare, LLC | Home Health | 200 N. Pacific Coast Highway, Suite 300, El Segundo, CA 90245 | 2013-03-21 |
| Find all providers in zip 90245 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104628 | Ann Egan | Counselor | 207 Cole St, San Francisco, CA 94117-1915 | 2020-11-07 |
| 1821698887 | Ka Yin Emma Liu | Counselor | 1936 University Avenue, Partnerships for Trauma Recover, Suite 191, Berkeley, CA 94704 | 2020-10-29 |
| 1184224693 | Enrique L Hinojosa | Counselor | 817 S Fairmont Ave, Lodi, CA 95240-5116 | 2020-10-26 |
| 1760081376 | Annel Vianey Orduno | Counselor | 3517 Camino Del Rio South Suite 407, San Diego, CA 92108-4026 | 2020-10-23 |
| 1114526407 | David Arthur Lee | Counselor | 1819 Idaho Ave, Santa Monica, CA 90403-3301 | 2020-10-19 |
| 1235737271 | Jeannie Dulberg | Counselor | 540 Wagnon Rd, Sebastopol, CA 95472-9204 | 2020-10-12 |
| 1952909210 | Christopher Shirey | Counselor | 1618 Alhambra Blvd, Sacramento, CA 95816-7601 | 2020-10-09 |
| 1467059105 | Paul Benjamin Mannes | Counselor | 59922 La Brisa Dr, Yucca Valley, CA 92284-9351 | 2020-10-06 |
| 1689271454 | Skycare Cuidado Del Cielo LLC | Counselor | 7890 E Spring St Unit 10d, Long Beach, CA 90815-1622 | 2020-10-05 |
| 1396342135 | Lima Karim | Counselor | 4109 Broadmoor Cmn Apt 207, Fremont, CA 94538-7013 | 2020-10-05 |
| Find all providers with the same taxonomy | ||||
| City | EL SEGUNDO |
| Zip Code | 90245 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.