Doctor Name: | JANE KIM |
NPI Number: | 1023232493 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 335 E Lake Ave Watsonville, CA - 95076 |
Business Phone Number: | 8317286445 |
Business Fax Number: | 8317616011 |
Mailing Address: | 335 East Lake Ave, WATSONVILLE |
State: | CA |
Postal Code: | 95076 |
Phone Number: | 8317286445 |
Fax Number: | |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 08/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |