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General NPI Number Information
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NPI Number | 1134836000
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Entity Type | Organization
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Legal Business Name | K THERAPY FOR RESTORATION, INC
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 265 S. RANDOLPH AVE. #185
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City | BREA
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State | CA
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Zip | 92821
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Country | US
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Telephone | 657-377-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 265 S. RANDOLPH AVE #185
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City | BREA
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State | CA
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Zip | 92821
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | EUI JEAN KIM
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Credential | LMFT
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Telephone | 657-377-5522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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