Provider Demographics
NPI:1912339631
Name:KIM, VIOLETA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VIOLETA
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VIOLETA
Other - Middle Name:
Other - Last Name:LORETO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:17707 STUDEBAKER RD
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2640
Mailing Address - Country:US
Mailing Address - Phone:213-247-5342
Mailing Address - Fax:
Practice Address - Street 1:17707 STUDEBAKER RD # 208
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2640
Practice Address - Country:US
Practice Address - Phone:562-402-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker