Provider Demographics
NPI:1659573459
Name:DELIEMA, KIM ELISE (MSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KIM
Middle Name:ELISE
Last Name:DELIEMA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:MEYEROWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 S MAIN ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4507
Mailing Address - Country:US
Mailing Address - Phone:805-252-3181
Mailing Address - Fax:
Practice Address - Street 1:26932 OSO PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5815
Practice Address - Country:US
Practice Address - Phone:949-374-4486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health