Provider Demographics
NPI:1083388938
Name:SOLEIMANI SHIM, ESTHER (ACSW)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:SOLEIMANI SHIM
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 W CAMERON AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2726
Mailing Address - Country:US
Mailing Address - Phone:626-653-9913
Mailing Address - Fax:
Practice Address - Street 1:1515 W CAMERON AVE STE 210
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2726
Practice Address - Country:US
Practice Address - Phone:626-653-9913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95493101YM0800X
CAACSW95493104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker