Provider Demographics
NPI:1215820816
Name:YIM, SARAH (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:
Last Name:YIM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 W AVENUE 26 APT 411
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-1489
Mailing Address - Country:US
Mailing Address - Phone:262-498-0294
Mailing Address - Fax:
Practice Address - Street 1:6528 GREENLEAF AVE STE 133
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4107
Practice Address - Country:US
Practice Address - Phone:562-900-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist