Elli S Kim
Marriage & Family Therapist in Los Angeles, CA. Individual provider (NPI-1).
NPI number1063149482
StatusActive
Last updated in NPPESFeb 28, 2024
Details
- NPI
- 1063149482
- Entity type
- Individual (NPI-1)
- Name
- Elli S Kim
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 5, 2022
- Certification date
- Feb 28, 2024
- Last updated
- Feb 28, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | AMFT144883 | CA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | |
| 225400000X | Rehabilitation Practitioner | – | – | |
| 101YP2500X | Counselor, Professional | APCC15137 | CA |
Practice location
840 N Avenue 66Los Angeles, CA 90042-1508
Phone 626-395-7100
Mailing address
24153 Del Monte Dr Unit 363Valencia, CA 91355-3801
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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