Provider Demographics
NPI:1346599529
Name:LIM, GRACE EUNHAY (BSN)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:EUNHAY
Last Name:LIM
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 E. GONZALES RD STE 102
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0619
Mailing Address - Country:US
Mailing Address - Phone:805-981-5146
Mailing Address - Fax:805-981-5385
Practice Address - Street 1:2220 E GONZALES RD STE 102
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-8293
Practice Address - Country:US
Practice Address - Phone:805-981-5146
Practice Address - Fax:805-981-5385
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator