Provider Demographics
NPI:1407118409
Name:KIM, JI-HYUN (LMFT)
Entity Type:Individual
Prefix:
First Name:JI-HYUN
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 CORDELL CT
Mailing Address - Street 2:STE. 101
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-0914
Mailing Address - Country:US
Mailing Address - Phone:619-448-9700
Mailing Address - Fax:
Practice Address - Street 1:1870 CORDELL CT
Practice Address - Street 2:STE. 101
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-0914
Practice Address - Country:US
Practice Address - Phone:619-448-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 106H00000X
CA104776106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health