Provider Demographics
NPI:1912727934
Name:YOON, NAMSIK
Entity type:Individual
Prefix:
First Name:NAMSIK
Middle Name:
Last Name:YOON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 S NEW ENGLAND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-5314
Mailing Address - Country:US
Mailing Address - Phone:213-713-8180
Mailing Address - Fax:
Practice Address - Street 1:1812 S NEW ENGLAND ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5314
Practice Address - Country:US
Practice Address - Phone:213-713-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1213761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical