PATRICIA KIM (NPI# 1740651280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740651280 |
| Entity Type | Individual |
| Full Name | PATRICIA KIM |
| Credential | PH.D. |
| Practice Address |
10560 Main St Ste 518 Fairfax VA 22030 |
| Mailing Address |
348 Northwood Way #1 Palisades Park NJ 07650-1952 |
| Practice Telephone | 7033492999 |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2019-09-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0810006266 | VA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 348 Northwood Way, #1, Palisades Park, NJ 076501952 | 7039552353 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386857480 | Patricia Kim | Acupuncturist | 1357 N Highland Ave, Los Angeles, CA 90028-7608 | 2007-05-07 |
| 1295798536 | Patricia Kim | Optometrist | 877 Ralston Ave, Belmont, CA 94002-2205 | 2006-04-08 |
| 1598394413 | Patricia Kim | Student in an Organized Health Care Education/Training Program | 101 The City Dr S, Orange, CA 92868-3201 | 2020-04-02 |
| 1194222679 | Patricia Kim | Social Worker | 136 Madison Ave Fl 6, New York, NY 10016-6795 | 2018-04-10 |
| 1487172045 | Patricia Jeannie Kim | Acupuncturist | 133 Kearny St Ste 304, San Francisco, CA 94108-4811 | 2017-09-05 |
| 1750701934 | Patricia Kim | Registered Nurse | 1221 Madison St Ste 600, Seattle, WA 98104-1364 | 2014-04-25 |
| 1881914216 | Patricia J Kim | Assistant, Podiatric | 185 Pilgrim Rd, Boston, MA 02215-5324 | 2010-06-08 |
| 1770771008 | Patricia Mitori Kim | Pathology | 347 N Kuakini St, Honolulu, HI 96817-2336 | 2007-10-11 |
| Street Address |
10560 MAIN ST STE 518 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205239118 | Tamar Ares | Counselor | 10560 Main St Ste 518, Fairfax, VA 22030-7173 | 2014-10-06 |
| 1750997029 | Nancy Sanderson Baker | Counselor | 10560 Main St Ste 518, Fairfax, VA 22030-7173 | 2020-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699232173 | Alexis Melville | Psychologist | 4094 Majestic Ln Unit 315, Fairfax, VA 22033-2104 | 2019-02-21 |
| 1558867333 | Kyoung Deok Baik | Psychologist | 3554 Chain Bridge Rd Ste 103, Fairfax, VA 22030-2709 | 2018-04-02 |
| 1265849822 | Shushan Campbell | Psychologist | 10521 Rosehaven St Ste 100, Fairfax, VA 22030-2877 | 2014-07-16 |
| 1679994867 | Claire Bartick | Psychologist | 9707 Commonwealth Blvd, Fairfax, VA 22032-2824 | 2013-12-15 |
| 1972933364 | Kim Havenner | Psychologist | 10805 Main St Ste 500, Fairfax, VA 22030-4747 | 2013-11-21 |
| 1912348343 | Tanisha S Bracey | Psychologist | 5403 Cabot Ridge Ct, Fairfax, VA 22032-3214 | 2013-07-15 |
| 1477833168 | Leslie Ann Hawkins | Psychologist | 9840 Main St Ste 201, Fairfax, VA 22031-3909 | 2011-08-25 |
| 1982998910 | Barbara G Smith | Psychologist | 11216 Waples Mill Road, Suite 104, Fairfax, VA 22030 | 2011-06-07 |
| 1184918401 | Martina Pavlicek | Psychologist | 11130 Fairfax Blvd Ste 305, Fairfax, VA 22030-5035 | 2011-06-03 |
| 1821303264 | Lianna R Bennett | Psychologist | 3607 Chain Bridge Rd, Ste A, Fairfax, VA 22030-3242 | 2010-08-10 |
| Find all providers in FAIRFAX | ||||
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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.