Healthcare Provider Details

I. General information

NPI: 1093766834
Provider Name (Legal Business Name): KAREN CHENG LIM PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 SOUTH LAFAYETTE PK. PL. 3RD FLOOR
LOS ANGELES CA
90057
US

IV. Provider business mailing address

520 SOUTH LAFAYETTE PK. PL. 3RD FLOOR
LOS ANGELES CA
90057
US

V. Phone/Fax

Practice location:
  • Phone: 213-252-2100
  • Fax: 213-383-3146
Mailing address:
  • Phone: 213-252-2100
  • Fax: 213-383-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY18342
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: