Healthcare Provider Details

I. General information

NPI: 1912548652
Provider Name (Legal Business Name): SOFIA KARIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 PINE AVE
LONG BEACH CA
90813-5818
US

IV. Provider business mailing address

838 PINE AVE UNIT 111
LONG BEACH CA
90813-5821
US

V. Phone/Fax

Practice location:
  • Phone: 714-423-4827
  • Fax:
Mailing address:
  • Phone: 144-234-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100841
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: