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General NPI Number Information
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NPI Number | 1255922829
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Entity Type | Organization
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Legal Business Name | VRIENDS CORP
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 02/19/2022
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Provider Practice Location Address
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Address Line | 5402 COKE AVE
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City | LAKEWOOD
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State | CA
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Zip | 90712-1626
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Country | US
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Telephone | 415-328-2226
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Fax |
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Provider Business Mailing Address
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Address Line | 5402 COKE AVE
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City | LAKEWOOD
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State | CA
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Zip | 90712-1626
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Country | US
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Telephone | 415-328-2226
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JUNG SUN SUNNY KIM
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Credential | PHD, BCBA
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Telephone | 415-328-2226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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