MEDICARE: JI EUN MIDLAM LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	23030	CA

General Provider Information

NPI Number	:	1861791634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JI EUN MIDLAM LCSW

Provider Business Mailing Address
First Line	:	7710 HAZARD CENTER DR STE E107
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4550
Country	:	US
Telephone Number	:	323-236-4685
Fax Number	:

Provider Business Practice Location Address
First Line	:	5694 MISSION CENTER RD STE 602-497
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4355
Country	:	US
Telephone Number	:	619-543-1613
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2011
Last Update Date	:	05/13/2025

Similar Medicare Providers

1043464985 — KENTARO NOGUCHI MA
Practice Location Address:

5694 MISSION CENTER RD STE 602-892
SAN DIEGO, CA
92108-4355

Practice Phone: 619-909-7639
Practice Fax: 619-815-4254

1306176383 — KIMBERLY PRIDA M.S.W., BCBA
Practice Location Address:

5694 MISSION CENTER RD , SUITE 602, PMB 341
SAN DIEGO, CA
92108-4355

Practice Phone: 619-840-9993
Practice Fax: 619-220-0215

1720318702 — ERIN DYER RING PH.D., BCBA-D
Practice Location Address:

5694 MISSION CENTER RD , SUITE 602 PMB 341
SAN DIEGO, CA
92108-4355

Practice Phone: 619-540-0676
Practice Fax: 619-220-0215

1710218755 — MRS. MAGGIE LEUNG MA M.A., BCBA
Practice Location Address:

5694 MISSION CENTER RD , SUITE 602 PMB 341
SAN DIEGO, CA
92108-4355

Practice Phone: 510-213-8583
Practice Fax: 619-220-0215

1659649754 — PHYSICIANS HOME AND HEALTH CARE
Practice Location Address:

5694 MISSION CENTER RD , SUITE 602/346
SAN DIEGO, CA
92108-4355

Practice Phone: 619-212-7950
Practice Fax: 619-212-7940

1487929287 — MISS ELIZABETH ROBERTS M.A., BCBA
Practice Location Address:

5694 MISSION CENTER RD , SUITE 602, PMB 341
SAN DIEGO, CA
92108-4355

Practice Phone: 619-985-7344
Practice Fax: 619-220-0215

Directions to “ JI EUN MIDLAM LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.