Provider Demographics
NPI:1689987281
Name:BOYKIN-JOHNSON, KIM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:
Last Name:BOYKIN-JOHNSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16255 VENTURA BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2310
Mailing Address - Country:US
Mailing Address - Phone:855-427-2778
Mailing Address - Fax:213-784-5690
Practice Address - Street 1:16255 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2302
Practice Address - Country:US
Practice Address - Phone:855-427-2778
Practice Address - Fax:213-784-5690
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16047103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical