Healthcare Provider Details
I. General information
NPI: 1306961099
Provider Name (Legal Business Name): MS. YUJIN KIM YUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/20/2007
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17871 PARK PLAZA DR STE 140
CERRITOS CA
90703-9500
US
IV. Provider business mailing address
3835 N FREEWAY BLVD STE 100
SACRAMENTO CA
95834-1954
US
V. Phone/Fax
- Phone: 855-501-1004
- Fax:
- Phone: 855-501-1004
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 44543 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: