Healthcare Provider Details

I. General information

NPI: 1215843693
Provider Name (Legal Business Name): KIM VU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 HOWE AVE
SACRAMENTO CA
95825-0132
US

IV. Provider business mailing address

2404 HOWE AVE
SACRAMENTO CA
95825-0132
US

V. Phone/Fax

Practice location:
  • Phone: 916-340-4171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC22003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: