Provider Demographics
NPI:1760979025
Name:KIM, AERIM ERIN
Entity Type:Individual
Prefix:
First Name:AERIM
Middle Name:ERIN
Last Name:KIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16172 AVENIDA SAN MIGUEL
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-3454
Mailing Address - Country:US
Mailing Address - Phone:714-883-1111
Mailing Address - Fax:714-739-3333
Practice Address - Street 1:3630 MACARTHUR BLVD STE C
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6871
Practice Address - Country:US
Practice Address - Phone:504-301-1555
Practice Address - Fax:504-301-1988
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-21
Last Update Date:2018-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health