Kim, Jeanne

Kim, Jeanne is an sole proprietor health care provider with primary practice located at 21053 Devonshire St Suite 101, Chatsworth CA 91311-2364. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Kim, Jeanne can be contacted via phone (818) 726-5326.

Contact Information

Primary practice address
21053 Devonshire St Suite 101 Chatsworth CA 91311-2364
Phone: (818) 726-5326
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X PSY22888 California
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY22888 California
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X PSY22888 California
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY 22888 California

Profile Details

NPI number 1447589692
LBN Legal business name Kim, Jeanne
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 17th, 2009
Last updated Sep 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447589692 NPPES
California MEDICAID PSY228880

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