Provider Demographics
NPI:1528480332
Name:KIM, EUI JEAN
Entity type:Individual
Prefix:
First Name:EUI
Middle Name:JEAN
Last Name:KIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7212 ORANGETHORPE AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3341
Mailing Address - Country:US
Mailing Address - Phone:714-449-1125
Mailing Address - Fax:714-562-8729
Practice Address - Street 1:7212 ORANGETHORPE AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3341
Practice Address - Country:US
Practice Address - Phone:714-449-1125
Practice Address - Fax:714-562-8729
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist