Healthcare Provider Details

I. General information

NPI: 1831676311
Provider Name (Legal Business Name): LAURA KAYLA LIM LCSW, PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET ST
VENTURA CA
93003-7783
US

IV. Provider business mailing address

317 S PRIMROSE AVE
MONROVIA CA
91016-2858
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-7598
  • Fax:
Mailing address:
  • Phone: 626-292-4488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number69532
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: