Provider Demographics
NPI:1992221857
Name:KIM, YOUNGEUN (LMFT)
Entity type:Individual
Prefix:
First Name:YOUNGEUN
Middle Name:
Last Name:KIM
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3680 WILSHIRE BLVD STE P04
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2709
Mailing Address - Country:US
Mailing Address - Phone:213-293-8533
Mailing Address - Fax:
Practice Address - Street 1:3680 WILSHIRE BLVD STE P04
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2709
Practice Address - Country:US
Practice Address - Phone:213-293-8533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA126294106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program