Provider Demographics
NPI:1205680113
Name:SOULH KIKI S CORNER CORP
Entity type:Organization
Organization Name:SOULH KIKI S CORNER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIMI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-854-9987
Mailing Address - Street 1:17809 HALSTED ST UNIT 316
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-2069
Mailing Address - Country:US
Mailing Address - Phone:805-222-6371
Mailing Address - Fax:
Practice Address - Street 1:22801 VENTURA BLVD STE 301
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1222
Practice Address - Country:US
Practice Address - Phone:805-222-6371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty