Provider Demographics
NPI:1285281337
Name:PARK, EUNA LIM
Entity type:Individual
Prefix:
First Name:EUNA
Middle Name:LIM
Last Name:PARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EUN A
Other - Middle Name:
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2687 E PACIFIC CT
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-9104
Mailing Address - Country:US
Mailing Address - Phone:714-865-9288
Mailing Address - Fax:
Practice Address - Street 1:7212 ORANGETHORPE AVE STE 9A
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-4668
Practice Address - Country:US
Practice Address - Phone:714-503-6550
Practice Address - Fax:714-509-0886
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111411101Y00000X
CA1277711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty