Provider Demographics
NPI:1275244527
Name:LIM, SUN YOUNG (ASW)
Entity Type:Individual
Prefix:
First Name:SUN YOUNG
Middle Name:
Last Name:LIM
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:SUNNY
Other - Middle Name:
Other - Last Name:LIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11947 VALLEY VIEW ST
Mailing Address - Street 2:# 5442
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3605 LONG BEACH BLVD STE 327
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-6021
Practice Address - Country:US
Practice Address - Phone:213-513-6358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105437390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program